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.