Will a lower bleph and facelift help? My eyes make me look ancient and I'm only 52! (photos)

I have a connective tissue disorder which makes "stimulating collegan" treatments ineffective. I feel I've tried just about everything besides surgery. I wonder if the C02 would work or a chemical peel? I just don't know anymore. How effective are fat transfers? Any suggestions or help is greatly appreciated! Thank you.

Doctor Answers 14

Wrinkles around the eyes

Dear Redkirk,

This is a really great question.  A neuromodulator, like Botox, Xeomin or Dysport, would be excellent for wrinkle reduction in the periocular area. After seeing how much reduction a full treatment provides you may or may not wish to have CO2 laser or chemical peeling in the same area. The combination of procedures provide a superior clinical result than when performed individually.  I hope this helps you find the right answer for you.

Be healthy and be well,

James M. Ridgway, M.D., FACS


Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 78 reviews

With prominent crow's feet

Botox helps prevent this by weakening the muscles that are causing this and laser will help smooth the surface so when relaxed, the skin will be much smoother.  Laser has risks that you  have to be willing to accept.  I'm not sure what kind of CT disorder you have but non-invasive methods employing radiofrequency and magnetic fields such as Venus Legacy may help if you don't want any downtime.  Facelifts will not help your area of concern at all.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Crows feet.

Thank you for your question. From the picture,  the lines radiating from the eyes are formed by the dynamic action of the underlying muscle. Relaxing this muscle with Botox can soften these wrinkles.  Once the lines are etched in, they may persist even without movement. These lines can be further softened by laser or chemical peel and even the right type of fillers.  Surgery is probably not your best option if this is your primary concern. The specifics of your connective tissue disease may need to be considered in your treatment plan. 

Stephen Fink, DO FAOCO
Newport Beach Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Treatment of crows feet.

Your photos shows crows feet and IMO the very best treatment for this is Botox.  Botox will relax the underlying muscle that is causing the wrinkles.  Facelifts and blepharoplasty don't really address crows feet. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

Wrinkles around the eyes

Hi there,

Thank you for your question and photos. My recommendation would be that you try botox for the wrinkles around the eyes. Sometimes it takes 2 or 3 sessions to better smooth the lines, but you should see improvement. You can also consider laser resurfacing, particularly is you are noticing the lines stay even when you are not smiling. Another good trick for the lines around the eyes is that sometimes adding a little bit of filler on the cheek bones can help support that area and will shorten the smile lines (so that they don't extent down as far).

Hope this advice is helpful. I would go to an experienced injector and ask for their advice.

Thank you

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Botox for dynamic wrinkles

From the photos posted, its certain that botox would help with the dynamic wrinkles (the ones that appear when you smile). However with time, dynamic wrinkles will turn into static (permanent wrinkles). If the wrinkles are there even if you don't smile, then botox will not get rid of them. At that point laser resurfacing or chemical peels are the best way to improve those wrinkles.

As far as a face lift goes, its impossible to determine whether you would benefit from the photos that you have posted. We need to see a full face photo from the front, oblique view, and profile view so that we can assess your jawline and your neckline. These are the areas that a face and neck lift will improve. 

Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 33 reviews

Will a lower bleph and facelift help? My eyes make me look ancient and I'm only 52!

Thank you for your photos and question.  You have very typical and prominent crow's feet that usually respond dramatically to Botox injections every 3 to 4 months.  The other option to consider would be a fractionated CO2 peel such as active FX but I need to know more about the details of your collagen disorder before making a firm recommendation.  My suggestion would be to try Xeomin or Botox injection first to see how satisfied you are with the treatment is easy and very safe.  Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Thinking about lower bleph and facelilft

From the photos, all that I see are crows' feet which respond to Botox. Lower bleph and facelift will not help. If you have some dark circle in the lower lids, a little filler such as Belotero or Bellafill will help there.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 32 reviews

Lower eyelid surgery and a facelift

A full set of facial photographs are required to make a determination about these 2 surgical procedures. When patients have crows feet, Botox is the best option. The primary goal of lower eyelid surgery is to remove the fat bags located in the lower lids creating the tired look. The significant dynamic smile lines are not treated by a lower blepharoplasty procedure. The primary goal for a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove any fatty deposits located in the neck. For more information and many examples, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

No laser resurfacing

With a connective tissue disorder, I would advise against laser resurfacing. Depending upon your disorder, surgery may not be a good idea either. You might want to try PRP, or fat SVF injections. Good luck!

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews

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.