30 Years Old and Very Bad Under Eye Bags and Extremely Wrinkled Skin - What is the Best
Procedure to Fix This?
I am 30 years old and genetics have blessed me with extremely thin eye skin and under
eye bags, aging me beyond my years.
I am most concerned with removing the excess skin/wrinkles under my eye that get much worse
when I smile and also the bags.
Would a fat removal or transfer help?
I find it hard to smile when talking to someone face to face knowing they will see how terrible
my wrinkles look.
My skin elasticity is pretty bad.
What can be done?
Thank you for your question.
You're 30 yrs old and genetics has, as your wrote, has blessed you with puffiness and
wrinkled skin under the eyes and which appears age you well beyond your years.
Well certainly this reflective of a my descriptions in my book "The Fine Art of Looking Younger"
and understanding very well that puffiness and wrinkled skin under the eyes certainly
does make you look older than your age.
So what are your options?
Well there are certainly a few options understanding first what each anatomical issue is and then
developing a strategy is very important.
Now when you meet different doctors you will get different opinions so I'm simply going
to share with you what is typically what I do in my practice and if other doctors disagree,
I'm not going to say necessary they are wrong but everyone has their own personal style
and when you do your research you'll figure out what's best for you.
When people come to me for puffiness, I first teach them that the puffiness under the eyes
is always there regardless of allergies, sinuses or getting enough sleep and is more likely
something called lower eyelid fat prolapse.
Now you are right on target because genetics is such an important factor within the same
family.
I operated with 3 generations and so certainly it runs in families.
So this fat prolapse is herniated fat that pushes forward and regardless of the amount
of sleep or any other topical treatment it won't change.
Now on younger people like yourself, I generally do a procedure called transconjunctival blepharoplasty.
Now transconjunctival blepharoplasty means what I do is go from the inside of the eyelid
and I address the fat pockets.
Now there is a combination procedure such as resecting and removal as well as repositioning
that we perform based on the individual anatomic situation and what is great about this approach
is there is no external incision there is no compromise to the anatomy of the support
system of the lower eyelid.
A very popular approach to lower eyelid surgery mostly done by general plastic surgeons is
an external or transcutaneous blepharoplasty and someone like yourself who is complaining
of wrinkled skin maybe perceived or diagnosed as having too much skin and in my experience,
that is not generally the case in someone as young as you, and unfortunately the very
young people have had very bad experience where skin was removed and they end up getting
widen scar in the outside and eyelids gets pulled down in a condition called lower eyelid
retraction.
So you have to be mindful and very careful about making the decision over having the
procedure done from the outside.
You see, I try to teach my patients the difference between skin excess or redundancy and skin
quality the skin quality is the issue for you its thin, its genetically thin certainly
other environmental factors such as smoking and sun exposure can further age the skin.
Now in our practice, we have a couple of different approaches that helps skin quality and it's
not only a one time procedure.
Lower eyelid puffiness can be a onetime procedure but skin quality generally requires some type
of ongoing care because skin is living and changing but what we will typically do with
the lower eyelid blepharoplasty is we will do the injection of platelet-rich plasma.
Platelet-rich plasma is the serum of blood after being spun down.
The serum above the red blood cell separated and is rich in platelets.
Platelets are the cells that are responsible for healing when you get a cut.
So we have had very good results with injecting platelet-rich plasma under the skin and essentially
stimulating the collagen remodeling that improves the quality of the skin and it also has something
called vascular endothelial growth factors which stimulates blood flow and blood supply
and then makes platelet-rich plasma very unique than any other type of filler so we do that
and some people.
Depending in the skin, we'll do fractional Co2 laser or will do radio frequency such
radio frequency, Pelleve to help maybe tighten the skin again.
We do this in a very case by case basis.
On top of that, we will also do a very steady enhancement using topical skin care products.
We happen to have our own skin care line and we have a product called eye rescue as well
as different strengths of retinols and when I designed these products, I wanted to be
used that the products will have good moisturizing capability as well as good cell turnover.
And so some people will actually also use topical vitamin C and will just customize
these topical products.
Unfortunately topical products sold over the counter have limited amount in their active
ingredients and the FTA and FTC actually limits how much of those active ingredients can be
on a topical product that's over the counter.
Our products which are dispensed through our office is dispensed under supervision so we
have the luxury being able to have this active ingredients stronger.
And so this a combination of approach that is basically the take home message is improving
skin quality is not a onetime thing but a lot of difference can be made and sometimes
it doesn't have to be so complicated or so involved.
Very often with the platelet-rich plasma, the topical treatment such as fractional Co2
laser, we get really nice results and we just tell our patients wear sun block, drink lots
of water, avoid toxins such as cigarette smokers.
So I think the next step for you is to now meet with qualified experienced cosmetic surgeons
who has done a lot of eyelid surgeries and who are able to handle any of the challenges
and are not limited by 1 or 2 particular specific methods and you will get the feel of basically
their work, their results and portfolios and as well as the dialogue you have with the
doctor in terms of them resonating with you and you being able to feel comfortable and
confident in their ability to do their work.
So I hope that was helpful and thank you for your question.