Should I have surgery for under eye wrinkles? Under eye wrinkles
are a common problem, and often the first thing people recognize
as a sign of aging. Since your eyes are so important in communication,
a less than optimal appearance of your eyes can have a negative
effect on how you are perceived. I often see in consultation
patients who pull on their lower eyelid skin which show a
smoothing of these wrinkles. They believe that they have extra
skin which should be surgically removed. Unfortunately, many surgeons
also believe this is the case, so they do remove a significant
amount of lower eyelid skin. This often results in undesirable
changes in the shape of the lower eyelids as well as complications,
which can affect eye health. I’ll discuss how I address under eye
wrinkles in my practice and the steps I take to minimize the
risk of complications. I’m Dr Amiya Prasad. I’m a Board Certified
Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic and
Reconstructive Surgeon. I’ve been in practice in Manhattan and
Long Island for over 20 years. A wide range cosmetic eyelid
procedures are at the core of my practice. As a
Cosmetic Oculoplastic surgeon, I also revise and restore
eyelid surgery complications from procedures originally performed by other doctors.
As stated earlier, approaching wrinkled skin in the lower
eyelids as a problem of excess is often a setup for complications
of eyelid position and consequently eye appearance and health.
The fact is that lower eyelid wrinkles is associated with changes
in skin quality, not excess skin quantity. Strategies to improve
under eye wrinkles are based on ways to improve the backbone of
the skin, the dermis and the superficial texture of the skin which
is the epidermis. It’s important to remember that eyelid skin is
about .5 mm in thickness and is the thinnest skin in the body.
For skin quality improvement at the dermal level I often use
platelet-rich plasma, or PRP to improve eyelid skin thickness
and health. PRP is a concentration of wound healing and growth
factors present in your own blood. We obtain it by drawing a
patient’s blood like what’s routinely done for blood tests,
then spin it to concentrate a clear, yellowish serum, which
is PRP. The PRP can be placed by injection as well by a skin
boosting device. The effect is to stimulate collagen, improve blood supply,
and thicken the skin, which all helps to improve wrinkles. When it comes
to laser treatment which is generally indicated for people with lighter
skin type, the strategy is to address both the epidermis and the dermis.
For example we perform a procedure with a long pulse Erbium laser
called “smooth eye”. The treatment uses laser to address the dermis
with removal of the epidermis. His avoids the need to take time off
while the skin heals. This procedure is done over several sessions
4-6 weeks apart. We often address under eye wrinkles at the same
time when I perform lower eyelid surgery for under eye bags. I often
use the fractional CO2 laser and apply PRP topically immediately
afterwards. For people with darker skin, I use a radiofrequency
technology such as Pelleve’ instead of laser. As is the case with
many cosmetic skin procedures, non-surgical under eye wrinkle treatment
requires ongoing care to keep the skin looking as good as possible.
This includes the use of topical creams such as in the retinol
family of products. In addition periodic treatment with PRP and
skin boosting can be beneficial. There is the occasional patient
who comes in with folds of skin which they’ve had their own life.
In this type of situation, I surgically remove the skin with a method
called the skin pinch. In my experience, under eye wrinkles can best
be treated non-surgically. It’s important to remember that the expectation
should be to improve the appearance of the wrinkles under the eyes and
not to eliminate them altogether. When it comes to determining which
approach would be best for you I recommend you find a doctor with
extensive experience with multiple modalities and you feel comfortable with.
This is important because optimal skin care requires a long-term strategy
I hope you found this information helpful…thank you for your question.