Question: I had eyelid surgery approximately two years ago, now I have small wrinkles under my eyes. Is this normal? I recently moved to Milwaukee and would like to know if you can remedy this and if it would require another surgery.
Answer: It is certainly not unusual for people to have a small amount of wrinkling under their eyes after a blepharoplasty since that is highly dependent on the patient’s skin elasticity as opposed to skin excess. I would have to evaluate you personally to determine whether or not you do truly have a skin excess or if it is just the inability of the skin to rebound when you squint, but there are options available that would not require you to undergo another surgical procedure. One would be some sort of laser resurfacing where the skin is treated to improve the collagen in the skin and this will then in turn improve skin texture, tightness, and wrinkle reduction. For a no downtime option, Ultherapy can actually be used on the lower eyelid skin especially the newer transducer that treats 1.5 mm below the surface. The results are not as significant as a full laser resurfacing but, considering there is absolutely no downtime involved with it, it certainly is still an option. If you do have a significant amount of excess skin causing the problem then you may want to consider a simple in office pinch procedure to the lower lids where the excess skin is removed, sutures are placed, and these are removed in three or four days. As you can see, there are a variety of options depending on your particular problem and tolerance of any downtime and I would, therefore, recommend a consultation with a board-certified facial plastic surgeon.