What will be the best treatment with long term results for my eyes? Drooping, sagging, and excess skin. (photos)

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Your best bet would be a blepharoplasty (eyelid surgery), which is used to remove excess or sagging skin above or below the eyes. I would consider doing some research into that! Potentially, a brow lift may offer some lifting, but it would change the placement of your brows slightly. There is also Botox, which would help to reduce the "crows feet" or creases to the outside of your eye as well.

Neurotoxin is the best preventative treatment for someone your age. You could potentially benefit from lower lid treatment and brow treatment but you need an in person consultation to discuss your goals.
Best to see an eyelid expert in your area.

Of course, aggressive, expensive surgery with its attendant significant post-surgical downtime is an option. If you are looking for a nonsurgical and minimally invasive approach for achieving your goals, you may wish to consider the use of microdroplets of Botox to treat the immediate bulge under the lower lids and elevate the lateral portions of the eyes, as well as a robust HA filler in the upper cheek regions (which are a very important support and buttress for the infraorbital region), in order to help to improve the under eyes. Finally, "The Ten Minute Eyelift," which is a simple, minimally invasive technique for tightening redundant, droopy upper eyelid skin, may used to complete the upper eyeld/brow rejuvenation. The Botox/filler treatments typically engender little to no signficant downtime and the "Ten Minute Eyelift," which I just performed yesterday on my wife, results in a few days of minimal crusts, such as the kind one might see from a small scrape. Hope this helps. Best of luck.

It is very difficult to asses perirbital area and eyelids when patient is smiling. A nes set of photos, full front view, or better, in person consultation with a board certified plastic surgeon, is recommended. Good luck.

An upper lid blepharoplasty where a crescent shaped area of skin is removed from the upper eyelid would be indicated. For the lower, just a small pinch of skin removed along the lash line should suffice.

Thank you for your question. While there are resurfacing and radiofrequency treatments available, by far the most effective and long-lasting treatment would be an upper and lower blepharoplasty (eyelid surgery). In both surgeries, excess skin is removed, and often in the case of lower eyelid surgery, fat pads may be reduced in size or moved to address puffiness. I hope this helps, and all the best to you.
Dr. P

Hi Nlynnwx3,
Well, there are several options. We can look in detail at your lids at rest versus when you are smiling. Botulinum, laser, filler, and blepharoplasty (both minimally invasive and standard) can all play a role in getting you a great long lasting result.

Hi there! If you haven't tried Botox, that's a great starting point. Placing Botox around the eyes and sometimes below can help with wrinkling and raising of the eyebrow. The amount of units varies but younger patients often need 4-6 units per side. I would avoid any surgical intervention until you've tried the minimally invasive options. A visit with a med spa to see what topical creams are available for tightening would be good. Surgical options include a lower blepharoplasty to reduce the fat present or an upper blepharoplasty for skin removal. Hope this helps!

A full set of facial photographs that are in focus are going to be required to make a determination about being a candidate for upper eyelid surgery and lower eyelid surgery. The primary goal of upper eyelid surgery is to remove the excess skin and a small amount of fat on the inner corners. The primary goal for lower eyelid surgery is to remove the fat bags and sometimes a small amount of skin at rest, not when smiling.