What's the Best Treatment for Loose Skin Under Eyes?

i'm 55. I have hollow eyes and have had some fillers used to treat a depression at the outer, lower aspect of the socket, but there is still an issue with some wrinkles caused by a little bit of loose skin. Is skin excision the best way to go?

Doctor Answers 15

Loose Lower Eyelid Skin

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A very careful examination with an experienced surgeon will guide you through your options.

You have very accurately identified the first goal in the most up to date approaches- additional volume.

It sounds as though you have identified a "lateral orbital hollow" as well as some loose skin.  In general I would recommend the following are considered:

1.)  Additional volume with "no down-time" such as Restylane, which you have completed.
2.)  Consideration for natural volume with your own abdominal fat transferred.
3.)  Botox or Dysport (your choice) to lessen the contractile forces of the periorbital muscles (crows feet).
4.)  Potential tightening skin procedures such as chemical peels or fractionated carbon dioxide lasers.
5.)  Removal of  excess skin with pinch blepharoplasty or skin-muscle flap blepharoplasty.

Obviously the best idea is to start with the least invasive and most natural options progressing only as needed to more advanced options.

Best of Luck to You!
Todd Hobgood, MD
Double Board Certified Facial Plastic Surgeon

Solutions for loose skin

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For slightly loose skin, laser skin resurfacing is a good options. The skin can be safely lasered right up to the lashes. In addition, the skin texture will be much nicer. An alternative would be lower eyelid blepharoplasty with fat transposition and excision of skin. This will help fill in your hollowed areas and smooth out the skin. 

Best treatment for loose skin under eyes

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At 55 years of age, the best option for loose skin underneath the eyelids is usually a pinch technique done at the subciliary line. This is a technique often done with lower blepharoplasty, but can be done independently. Immediately below the lash line 2 to 3 mm of excess skin is pinched from the lower lids. Tissue glue such as Histocryl is used to close the incision. Another option to help tighten the lower lid skin is fractional carbon dioxide laser resurfacing.

Laser and Eyelid surgery to correct loose lower lids

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Loose skin under the eyes usually responds well to carbon dioxide laser resurfacing.  The laser energy heats the  collagen fibers in the dermal layer of the skin resulting in contraction and tightening.  Traditional carbon-dioxide lasers such as the Ultra-Pulse laser work very well here, as do the newer fractional carbon-dioxide lasers such as the DOT therapy treatment. 

Another important factor in loose lower eyelid skin is the tone of the lid, itself.  In some cases, the lid is loose, and any tightening procedure such as laser resurfacing, may pull it down more.  In severe cases, the white of the eye may show beneath the iris because the lower lid has become excessively loose and/or rounded.  To correct and prevent this problem, it may be advisable to have a surgical procedure known as a canthopexy  which will lift and tighten the outer corner of the eye itself.  The canthopexy is often done at the same time as a blepharoplasty and laser resurfacing.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon

Treating loose skin under the eyes

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Skin excision may work very well for tightening up skin in the region you're describing. You might also be a candidate for a cheeklift procedure, which is completed though an incision in lower eyelid and has the advantage of being a form of mini-facelift and can also give some improvement in nasolabial fold region. Your skin, facial sturcture and personal wishes should be evaluated by a surgeon so that together you two can come up with the best treatment for you.

Deason Dunagan, MD
Huntsville Plastic Surgeon

Loose skin under eyes

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Fillers will correct hollowness along the lower lid cheek margin. It will not improve the loose lower eyelid skin.

Stop Bluffing and consider a Blepharoplasty

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Usually as we advance in age the eyelid skin loses its youthfulness.  Fillers are a reason nonsurgical way to improve this area.  These measures are temporary. Depending on your perspective and the result this may be a good or bad.  The best way to have a more lasting improvement is through a blepharoplasty.  Depending on the issues , a blepharoplasty can remove loose skin, aid in tightening of the skin and correction of hollowness.   Visit with several board certified plastic surgeons for opinions concerning your eyes.

Good luck.

Dr. ES

Correction of loose skin under the eyes

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The only way to correct loose skin under the eyes, particularly if you have already had fillers, is to remove the excess skin with a blepharoplasty or to do laser resurfacing or peel the area. What will work best for you will require a consultation with a plastic surgeon with experience in eyelid rejuvenation.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Operation to correct

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It's not that simple. Determining the proper operation is a complicated decision making process. This can be quite straightforward or exceptionally complex. It depends on how loose your skin relative to the laxity of the eyelid.

Loose skin under the eyes

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Loose skin under the eyes is caused by loss of elastin, collagen, and the effects of gravity as we age.  A blepharoplasty, or eyelid lift, can be performed to correct this.  Depending on whether there is bulging of the lower lid, a small amount of fat can be removed or repositioned to fill in hollowed areas.  A small amount of skin can be resected through an incision just below the lash line of the lower lid.  The scar is imperceptible.  If the skin is simply wrinkled and not too loose, laser resurfacing can help significantly in this region. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.