Lower Blepharoplasty For Wrinkles
Under Eye Wrinkle Treatment with Blepharoplasty
I agree that if the area under the eyes has fat bags and loose skin then a lower blepharoplasty must be performed either by transconjunctival or external approach. For fine lines I would use a ViPeel if there were no fat pads or significant loose skin
Lower eyelid rhytids (wrinkles)
Fractionated laser resurfacing and chemical peels are both effective at reducing lower eyelid rhytids and tightening the skin to some degree. We use both deep and active FX with good results. Laser is generally better than a TCA peel but is more expensive and takes longer to heal
TCA peels give quite good results and can be done as a simple office procedure without anesthesia. We also like full strength phenol for the lids. It can give results approaching the laser. All of these decision need to take into account the patients skin type and such
It is important to understand any resurfacing can basically treat the rhytids present at rest but there will always remain dynamic rhyids with smiling. There are good studies showing that Botox before the resurfacing will give a better result because the patient isn’t developing new rhytids during the healing phase
Resurfacing treatment for management of fine or significant wrinkles under the eyes
For management of fine or even more significant wrinkles under the eyes, I suggest that you consider some kind of resurfacing treatment. A fractional CO2 laser could be used or a tunable resurfacing laser could be used to smooth away the wrinkles and tighten the skin in this lower eyelid area
Why don’t you have your lower eyelids operated on also?
I don’t think Fraxel does much. Peels can help. But these things are promoted to avoid surgery. You are having surgery. A well performed lower blepharoplasty can create a smooth lower lid with a long lasting result
Most of our patients who have lower eyelid surgery have both the upper and lower lids done.
Ablative fractional laser resurfacing best for lower eyelid wrinkles
Chemical peeling can work very well for lower eyelid wrinkles. However, chemical peels can go too deep and cause pigmentation and or scarring if not done correctly. The same holds true for the fractional CO2 lasers, they must be done properly or complications can result
The most recent, up to date technique is a combined non-ablative Lux1440 and ablative Lux2940 laser resurfacing. These two fractional Erbium lasers are combined in one treatment and provide excellenmt wrinkle removal and skin rejuvenation with very little risk of scarring or delayed recovery
You may have to search a while for someone who uses this new technique, however it is an excellent innovation and worth the wait. The eyelids are very thin and susceptible to scarring if careful technique is not used
See before and after photos of fractional laser treatment.
Without the benefit of a photo it is hard to say what would work best for you. Most fine superficial wrinkles or even crepey skin is best treated with skin resurfacing by chemical peel or laser
Redundant skin or lower lid bags is best treated by surgical intervention.
Lower Eyelid Wrinkles
You have several options. Botox would help, but likely would not completely resolve your issues. Some form of skin resurfacing would also improve this region, either laser or a chemical peel. I also feel that you have a slight tear trough deformity which could be helped by filler, and it may add enough volume to help reduce the appearance of your wrinkles. (Satyen Undavia, MD, Philadelphia Facial Plastic Surgeon)
Under eye lines
This can give you almost a years worth of improvement. Sleep apnea is not a disease to fool with especially at your young age. You do not look like the typical sleep apnea patient and your symptoms may be easily treated with just allergy medications and possibly nasal surgery.
Seek out an injector experienced in your situation. Also look for a good ENT/Facial Plastic surgeon that maybe able to treat you completely! Your on your way to a better you! (Paul E. Goco, MD, Nashville Facial Plastic Surgeon)
Under eye smile wrinkles – how to treat?
Botox is the only answer. Wrinkles are caused by muscle contraction and Botox reduces the muscle activity. There is NO surgery that can correct eyelid wrinkles caused by smiling (Brooke R. Seckel, MD, FACS, Boston Plastic Surgeon)
Young with Lower Eyelid Wrinkles
The reason you have received a variety of treatment options is because nothing works great for your specific problem. The option I feel which would be most beneficial with little risk would be Botox injections followed 1-2 weeks later with erbium laser skin resurfacing.
This combined treatment approach is usually helpful, but not perfect given your situation. You should make an appointment with an Oculoplastic Surgeon for comprehensive evaluation and discussion of potential treatment options..
Are Incisions in Wrinkles in the Forehead Normal in Browlifts?
More often than not, if you get a mid forehead incision in the wrinkle crease it will not be as invisible as the trichophytic incision at the forehead hairline, and once you have a scar in the middle of your forehead you are stuck with it forever.
I hope you get another consultation elsewhere before deciding on that course of action. I am quite surprised a well trained plastic surgeon would look at you, with the hairstyle in your photo and even consider a midforehead wrinkle scar (especially when you say you don’t really have deep wrinkles).
Check credentials thoroughly for all consultants you see. (Ronald V. DeMars, MD, Portland Plastic Surgeon)
Mid forehead incisions for brow lift in smooth skin.
I would suggest that a trichophytic hairline incision would be a superior approach since you have a smooth forehead and wear your hair in bangs. In my practice it is the preferred approach. It does not take away hair, the scar can eventually be exposed as hair grows through it and the hairline can even be lowered if it is too high ( perhaps that is why bangs flatter your features).
If you do not have deep horizontal forehead wrinkles, brow lift scars in the mid forehead could very well be a problem. (Sheldon S. Kabaker, MD FACS, San Francisco Facial Plastic Surgeon)
Placement of incisions for forehead lifts.
For those patients with receding or elevated hairlines, a crease line incision is helpful. Often, an incision at the junction of the forehead skin and the hairline gives a wonderful result. Endoscopic lift may be a helpful technique, if applicable, in some cases.
The skin should be very smooth and muscle will be removed to limit frowning. You have some good options. (H. Michael Roark, MD, San Diego Plastic Surgeon)
I actually presented and authored an article in 1983 on the Mid-Forehad Lift. This is still a procedure used under certain circumstances by a limited number of surgeons. It is utilized more for males than it is for females.
Also it is easier to hide the incisions in those who have fairly well demarcated transverse forehead “wrinkles” . I noticed that you wear “bangs” anyway, so that may have been part of the decision making of your surgeon.
This is especially important if there is a transverse crease that has developed at the top of your nose. While it is difficult to determine from the single picture submitted it appears to me that you have reasonable eyebrow position and perhaps upper blepharoplasty alone is certainly another realistic option.
What can you do for wrinkled eyelids?
A photograph would be helpful so that we can provide better recommendations for treatment or surgery. There are lots of non-surgical and surgical options for wrinkles. Consultations with plastic surgeons in your local area will be the best way to determine the best options for your eyelids. (Gregory Park, MD, San Diego Plastic Surgeon)
There are many options for eyelid rejuvenation depending on what bothers you and your physical examination. If loose eyelid skin or fat bothers you, then the treatment is typically a surgery called lower blepharoplasty.
If you have droopy upper eyelids, then a ptosis repair may need to be performed. If the wrinkles around your eyes bother you, that may be addressed with either botox or skin resurfacing (chemical peel or laser).
You can express your concerns to your surgeon during your consultation and you can come up with a plan that works best. (Sanaz Harirchian, MD, Houston Facial Plastic Surgeon)
If the problem is excess upper lid skin – an upper lid lift will have excellent result.sFor lines on the lower lids, Botox and a peel or laser are usually a good start. (Elizabeth Morgan, MD, PhD, Atlanta Plastic Surgeon)
The clock never stops. So do not talk yourself into something you don’t need. The nonsurgical treatments, which require maintenance are very good. This included botox and under eye fillers. When these measures do not get the job done, sure, eyelid surgery can be very good.
You are in a part of the country where you may not have access to the best aesthetic surgery. Consider your options carefully. (Kenneth D. Steinsapir, MD, Beverly Hills Oculoplastic Surgeon)
Blepharoplasty combined with laser skin resurfacing
You would have good results with lower blepharoplasty combined with laser skin resurfacing. The extra skin would be removed and the wrinkles would be diminished. See an experienced eyelid specialist with both techniques. (James R. Gordon, MD, FACS, FAAO, New York Oculoplastic Surgeon)
Short answer, it looks like you would be a good candidate for lower blepharoplasty to help rejuvenate the area around your eyes. Obviously, you would require a physical exam to get a full appreciation of the anatomical issues around your eyes.
Blepharoplasty revision to get rid of under eye wrinkles
I recommend to try botox first to see if the orbicularis muscle can be in a resting state. If yes than how do you look. If happy than just use the Botox 3 to 4 times a year.
If not happy than consider a secondary lower lid operation. (Darryl J. Blinski, MD, Miami Plastic Surgeon)
It is interesting to me how people of a certain age develop the expectation of being wrinkle free when they never were wrinkle free. Smile line are normal and in fact tell people that our smiles are genuine.
Perhaps what you are really saying is that you do not like the crepey quality of the skin. Lot of surgeons my try to help you with this. The risk is that the more pulling that is done, the more damage can be done to the eyelid.
Phenol 89% chemical peels are probably the way to go but this needs to be done by a highly experienced chemical peeler. Filling the under eye with Restylane is also helpful. Personally, I think that you are likely to get into trouble with more lower eyelid surgery for this particular issue. (Kenneth D. Steinsapir, MD, Beverly Hills Oculoplastic Surgeon)
Lower eyelid surgery will not necessarily remove all the wrinkles from the skin, but you should obtain about a 60-70% improvement. Overresection of skin in this region can lead to an appearance of a pulled down lower eyelid showing too much “white” of the eye.
This should be avoided. Another option you may consider rather than repeat lower eyelid surgery (lower blepharoplasty), is laser resurfacing of the skin. This will help significantly with wrinkles and enhance the texture of the eyelid skin. (Etai Funk, MD, Houston Facial Plastic Surgeon)
CO2 laser can tighten lower eyelid skin, and is a great option for certain patients. It is particularly effective for fine lines and poor skin quality. However, if there is actually redundant or a true excess of skin, then surgical blepharoplasty is more effective.
There may be other surgical options as well (mid face, procedures, etc). You are young, so I understand why you started with non surgical options. Without photos, it’s difficult to give you the best advice.
I would schedule a consultation with an Oculoplastic surgeon to determine your options. (Ira Vidor, MD, Newport Beach Oculoplastic Surgeon)
What is the best treatment for thick skin and wrinkles of the lower eyelids?
You need comprehensive evaluation in person to guide you with the best approach to treat your specific problems. In general, lower eyelids can be tightened with surgery or with laser skin resurfacing. Some wrinkles can be removed with Botox. See an Oculoplastic Surgeon for detailed information. (James R. Gordon, MD, FACS, FAAO, New York Oculoplastic Surgeon)
Consultation with some experts in the field will be able to provide you answers to what procedures would best provide a natural looking result while still addressing your concerns. Botox is very effective for reducing the wrinkles around the eyes whether it would be enough would need to be determined at consultation.
You may need a combination of procedures that will provide you a more rested appearance.
Lower lid wrinkles and excess skin.
Your eyelid complaints are very common amongst both men and women over the age of 35-40. Meet with a Bd Certified plastic surgeon to discuss your many options and be certain to have realistic expectations.
A natural look is extremely important and should be achievable in the hands of an experienced specialist. Also, review the video link above for more detailed information. (Jon A. Perlman, MD, Beverly Hills Plastic Surgeon)
Do you even need eyelid surgery?
Before you go out and prescribe yourself lower eyelid surgery, you want to be pretty sure that this is actually what you need. Be aware that many minor issues for the lower eyelid can be profoundly helped with non-surgical methods.
On this website you will find approximate prices for procedures. Please recognize that a price does not mean that you need a given procedure. Find the right cosmetic surgeon who makes sense and knows their business.
Be open to non-surgical approaches because these are often better than surgery for many issues..
wrinkling under the eyes may be treated with various techniques that vary in price from laser or chemical peel resurfacing to a full blepharoplasty. So see some experts in the field that offer complimentary consultations and be evaluated.
Cost for blepharoplasty
Cost of cosmetic surgery depends on your location, your general health, the extent of problem being corrected, your general health, need for general anesthesia,your surgeon and the facility. It can range from $2500-$5000. It would be best if you consulted local Occuloplastic, facial plastic or general plastic surgeons for consultation. (Edwin Ishoo, MD, Cambridge Facial Plastic Surgeon)
Lower eye excess skin/thick wrinkles
Botox can dramatically improve wrinkles around the eyes or possibly a heavy laser procedure. But, if you have mostly loose skin only surgery can improve the area and done properly has a refreshed natural appearance.