Eyelid Surgery: Cost, Photos, Rewiews, Q&A

Wrinkling under eyelid

Wrinkles under the eyelid are not necessarily treated by a lower eyelid blepharoplasty. The fine lines and wrinkles are often treated with a skin resurfacing procedure such as a chemical peel or a CO2 laser peel (regular or fractional)

The lower eyelid blepharoplasty is aimed to treat bags under the eyed that result from fat pads that protrude with age. These should be better after blepharoplasty surgery.

Treating wrinkles after Blepharoplasty

Unfortunately, lower lid blepharoplasty is not a great procedure for wrinkling under the eyes. It is good for removing bulging, fat-causing bags.

Wrinkles under the eyes can be difficult to treat. Treatment may involve skin removal, fillers, or resurfacing procedures

While each case is different, the first important step is determining the cause of the wrinkles under your eyes, but again, this can be a tough problem.

Skin wrinkling after lower eyelid surgery should be left alone until fully healed from the operation.

It is impossible to make judgments about the aesthetic outcome of your operation 2 weeks after the procedure. You should wait until you are fully healed and then asses the results.

If wrinkling is persistent, there are various treatments that might help

Now is not the time to employ them.

Skin Issues Following Blepharoplasty

You should definitely wait longer before making any judgements about your surgical result. It may take up to several months for your skin to fully heal from the blepharoplasty. In the meantime, leave it alone other than your normal skin care routine

If there is persistence of the fine lines after adequate time to heal, you may be a candidate to have a chemical or laser peel to further augment your results.

Lower lid skin wrinkling after blepharoplasty

During the process of healing, skin growth is increased and you may experience a bit more accumulation of the upper layer of cells that makes the skin appear drier. This, along with stretched skin from swelling, may make fine wrinkles very prominent for several weeks

Allow the eyelids to heal and apply a little moisturizer to the skin. Be sure to discuss your concerns with you doctor.

Too early to evaluate excess skin after Blepharoplasty

2 weeks post-blepharoplasty is too early to evaluate the excess skin. There is often alot of swelling after a blepharoplasty, and you have to give the skin some time to go back to normal.

Wrinkling can occur if excess skin exists before blepharoplasty

Wrinkling after a lower blepharoplasty can occur if excess skin exists preoperatively. Once the fat is removed from the lower lids, excess wrinkling can occur if not addressed. On most patients over 50 years of age there is some wrinkling that is present, and this is removed through an incision located at the lash line, and a small conservative amount of skin is removed from the lower lids and closed with Histoacryl tissue adhesive

Lower lid wrinkling has many causes

A lower lid blepharoplasty can remove
1 – excess skin, 2) excess and herniated fat and 3) tighten the muscles and ligaments of the eyes. Surgeons have different techniques that address all or some of these problems. To address the herniated and bulging fat, surgeons can remove the fat from inside the eyelid (transconjunctival approach) or through an open approach (skin muscle flap)

The loose muscle and ligaments must be addressed through an open approach, but if the ligament is all that needs to be tightened then the surgery can be limited to the corner of the eye (lateral canthopexy)

To tighten the muscle as well, the open approach is needed. When considering the skin, the skin can be removed by laser resurfacing or surgical excision, either way, good surgeons always err on the side of removing too little skin , because the converse can lead to devastating complications

But in your case, it is quite common for the skin to appear dry and brittle as the swelling from surgery subsides and this may make the skin appear to have many wrinkles. The best thing to do is to relax and consult with your doctor regarding any topical creams that can help moisturize the skin

I have an under eye Jelly Roll and Wrinkles. What is the best treatment is to target this problem?

First try HA filler like restyle Silk with micro BOTOX injections. If happy than no surgery needed!

Wrinkles under eyes

You have some wrinkling under the eyes which is worse when you smile – as it is for everyone. There may be enough skin to benefit from having some excised. You also have some hollowing which creates more wrinkling.

Some filler into the tear trough would help add volume and decrease the wrinkles. Some laser resurfacing will also help with the skin texture. (John J. Martin, Jr., MD, Coral Gables Oculoplastic Surgeon)

Deep Forehead Wrinkles

Deep forehead wrinkles are usually due to the activation of the frontalis muscle. You are correct to assume that this is due to drooping eyelid skin. Botox in the forehead may result in further drooping of your eyelid. (Christopher Khorsandi, MD, Las Vegas Plastic Surgeon)

My forehead has deep wrinkles. Is this because my forehead muscles are used excessively to keep eyelids from drooping?

In many cases deep forehead wrinkles do result from an unconscious or conscious effort to elevate the eyebrows in order to improve eyelid drooping. A photo or an in person consultation is the best way to determine the optimal surgical treatment for you. (Gregory Park, MD, San Diego Plastic Surgeon)

Laser Blepharoplasty helps tighten skin

15 years ago, I put down the scalpel blade for the carbon dioxide (CO2) laser. The beauty of this laser for eyelid surgery is that it can be used to sculpt the fatty tissue of the delicate eyelid area.

The additional benefit is that it can be used simultaneously to tighten the skin without an excision. NO SCAR, NO LOWER EYELID INCISION, NO SCALPEL! Although you have already had eyelid surgery you can still benefit from CO2 laser resurfacing of the eyelid skin.

This will help to tighten the skin and diminish wrinkles over time. Speak with your cosmetic surgeon about this option. (Mark Berkowitz, MD, Sterling Heights Oculoplastic Surgeon)

Wrinkles after Blepharoplasty

In general terms, if too much fat is removed during Blepharoplasty you can be left with hollowness. There are many ways to correct this, including fillers and fat grafting.

Wrinkles may require skin tightening with surgery, lasers, or a chemical peel. Make sure that your surgeon is aware of your concerns. (Samuel Baharestani, MD, Long Island Oculoplastic Surgeon)

Trans-conjunctival lower blepharoplasty procedure

A trans-conjunctival lower blepharoplasty procedure involves removal of the bags underneath the lower lids through an incision on the inside lower eyelid. If patients have loose and inelastic skin after the bags have been removed, then a pinch technique of excess skin need to be removed from the outside lash line.

This is not a complication, it is a side effect. If too much fat has been removed, the lower lids can look too hollow. For more information and many before and after results, please see the link and the video below. (William Portuese, MD, Seattle Facial Plastic Surgeon)

Laser skin resurfacing

One of the great things about laser skin reusurfacing is that it works wonders on the eyelid skin. There are a number of options from CO2 to Erbium to some of the newer Fractional lasers.

I would find a plastic surgeon who has extensive expereince with lasers and is very comfortable working on the eyelids. (Robert M. Jensen, MD, Medford Plastic Surgeon)

Different types of peels

Depending on what type of peel you had, there are a variety of peels that affect wrinkled skin to varying degrees. A light peel, such a glycolic acid, might do very little while a deeper peel with the old-fashioned phenol or a CO2 laser ight be very effective.

Ask you surgeon about the options of other peels.(Robin T.W. Yuan, MD, Beverly Hills Plastic Surgeon)

Usually getting rid of eyelid folds requires surgery

Most of the time changing your eyelid folds requires surgery. The surgery is called a blepharoplasty and is performed with either regular local anesthesia or local anesthesia in addition to twilight sleep sedation. Some people have very droopy eyebrows which can contribute to eyelid folds as well

This is corrected with a forehead lift. However, some people have loss of fat under their eyebrows. This happens to most people as they get older. This loss of fat can also give the appearance of excess skin in the upper eyelids

This problem can be fixed non-surgically with Restylane or Juvederm injections. I would suggest that you see a qualified cosmetic surgeon to determine which option is best for you.

It sounds like you need difficult revisional surgery.

Of course I don’t really know what you look like. But you are miserable and it has been almost a year. So there is no reason to wait. See both a board certified plastic surgeon and an oculoplastic surgeon (eye surgeon who specializes in eyelids).

Ask to see lots of before and after pictures. How many revisions do they do? What is their exact plan? I am quite sure you can be made better..

You may need revision lower lid surgery

If you are close to one year after surgery and you have lower lid bags and extra skin you will need a revision sometime in the future. It is very hard to be accurate for the procedure you need without a picture but from your description you will require some orbicularis musle redraping in addition to fat manipulation. (Hisham Seify, MD, PhD, FACS, Orange County Plastic Surgeon)

Great candidate for a filler

You are a good candidate for a filler, probably Restylane is a good choice. I don’t really see any wrinkles but increased pigmentation, this will not improve. the hollowness will improve or what we call the tear trough.

see a board certified plastic surgeon that has experience injecting In this area and see some before and after pictures to understand what improves with a filler and what will not good luck. (Gloria de Olarte, MD, Pasadena Plastic Surgeon)

Under eye filler is your best option here.

Under eye Restylane has proven itself to be invaluable in improve even significant under eye hollows. Because the lower eyelid skin is so thin, placement of material here is a fussy procedue. You may need 1 to 2 ml of filler under each eye.

Under eye treatment is an advanced service that requires a very experienced injector for the best outcome. (Kenneth D. Steinsapir, MD, Beverly Hills Oculoplastic Surgeon)

Give it Time

Two weeks is definitely too soon to be talking about revision but I understand your frustration. Removal of skin from the lower lids a tricky and requires other procedures to be done at the same time such as a canthoplasty and cheek support.

You mention deep wrinkles. If the wrinkles are low on the eyelid, ie at the orbital rim. then removal of a small amount of skin from the superior part of the eyelid will not help.

This area can only really be helped by a midface lift or standard facelift. So give it time. Then consider laser or peels to help the wrinkles and if that doesn’t do it consider other surgery.(Christopher L. Hess, MD, Fairfax Plastic Surgeon)

Age 49: undereye wrinkles and loose skin. Think Thermi laser made it worse! Ultherapy? Halo? Blepharoplasty?

I would recommend that you start with CO2 fractional laser resurfacing. In my opinion, it is the single most effective modality for quickly reducing wrinkles around the eyes. I would also recommend continuing Botox around your eyes to keep new wrinkles at bay.

Make sure that you work with a specialist in eyelid procedures who is a laser specialist as well to get the safest and best results. If this doesn’t work then you are looking at a lower lid blepharoplasty to remove a portion of this damaged/aged skin. (Manish H. Shah, MD, FACS, Denver Plastic Surgeon)

Will Lower Eyelid Surgery Help with my Wrinkles Under the Eyes and my Bags?

Although lower eyelid surgery can help with wrinkles under the eyes and bags, you appear very young. It is a bit difficult to evaluate the anatomy from the single image, but a filler to the tear trough is less invasive and may help blend a couple of areas of concern. (Kenneth B. Hughes, MD, Los Angeles Plastic Surgeon)

Vision problems after blepharoplasty surgery is very rare

There have been rare reported cases of blindness and double vision after blepharoplasty surgery. Blindness is felt to be due to bleeding which extends to the area behind the eye, compressing the optic nerve. IA patient with severe uncontrolled high blood pressure might be at a greater risk for bleeding.

Double vision is also rare, and is probably due to injury to a small muscle behind the lower eyelid. Careful surgery by an experienced surgeon will minimize this possible complication.(Roger J. Oldham, MD, Bethesda Plastic Surgeon)