Wrinkle Treatment and Skin Tightening Advice?

I am now at the point where I definitely don't want to undergo tons of expensive treatments, getting no results to speak of. Does anything greatly tighten undereye skin and upper lids, or greatly reduce deep wrinkles above the mouth? Should I just bite the bullet and resign myself to an upper and lower eyelid surgery? I am worried about the downward pulling of the eye that I've heard can happen.

Doctor Answers 5

Skin Care, Blepharoplasty & Lip Resurfacing most cost effective.

Unfortunately, the only thing that will tighten the skin and reduce muscle folding around the eyes is a blepharoplasty. Although transconjunctival removal of fat can work on people with inherited extra fat, this probably will not work for what you describe. This should not be a problem, however, if the surgery is done by someone experienced in this type of surgery. Modern blepharoplasty removes the tissue from beside the eye, not under it, and supports the eyelid. This will generally prevent any lower lid droop.

The only thing that will get rid of the lines around the mouth is a resurfacing laser or a deep peel. The only way I do either of these is if the skin has been prepped with something to stabilize the pigment cells. This is especially important in you with a history of post-partum melasma. I generally use the Obagi® skin care system to do this. It has the advantage of further correcting the melasma and other pigmentary problems as well as thickening the collagen to give better support to the skin, and is much less expensive than other ways of doing this.

You have a significant amount of wrinkle like problems for someone your age. Usually when I see this, I am dealing with a smoker and/or sun worshiper, or both. If you are either, you need to change, or none of the above recommendations will help. Smoking is the worst thing you can do to your skin. It thins the collagen, causes wrinkles and increases other sun damage at an alarming rate. The sun also does the same. Therefore, stopping smoking and use of a good Zinc Oxide sunblock daily are vitally important to achieve any of your goals if you smoke or have a lifestyle other than a hermit.

Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Upper and lower blepharoplasty

The upper and lower blepharoplasty with incision at surgery is designed for removal of mostly excess skin on the upper lids with a small amount of puffiness or fat underneath the eyelids. The lower lids can also be tightened at the subciliary or lash line for excess skin. This must be done conservatively so as not to change the shape of the lower eyelids. The skin tightening wrinkle treatments do not seem to work very well in the lower eyelid area.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

You're not ready for surgery

By the tone in your question I can tell that you're not as open as you need to be. There are many options to treating the periorbita or eyelids. Some are as simple as Retin-A or skin care and others as complicated as surgery. You need to have a long consultation with a plastic surgeon who will explain each and every alternative including their pros and cons. Once you have all the correct information than you and your surgeon can come to the best decision for you.

So keep an open mind.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 34 reviews

Blepharoplasty is best option for wrinkling and laxity of eyelid skin

Laser resurfacing can help wrinkles around the eyes and mouth but results are disappointing if you have puffiness and excess eyelid skin.

Blepharoplasty is effective if done by an experienced board certified plastic surgeon.

Worry about the downward pull of the eyelid after blepharoplasty can be eliminated by finding a surgeon who is expert at transconjunctival blepharoplasty-the incision is placed on the inside pink portion of the eyelid thus no change in eyelid shape.

Effective removal of lip wrinkles requires laser resurfacing, filler injection, and botox combined--any less than all three will disappoint you.

See before and after photos of blepharoplasty.

Careful planning required

In general, there is a difference between skin laxity or loss of elasticity, and skin excess. If it is mainly loss of elasticity as evidenced by fine or coarse lines, then a resurfacing such as laser peel would be recommended. If it is excess of skin as evidenced by small rolls of skin or hanging of skin, then a skin excision type of blepharoplasty is indicated. Each procedure can substitute a bit for the other to some extent, but an accurate anaylsis and diagnosis will go a long way to pointing to the most specific treatment plan.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 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.