Due to the extreme thinness of lower eyelid skin, collagen loss is often first visible in this area. Patients often complain of crepiness or puffiness on their lower eyelid skin. While texture changes are strictly due to collagen loss, puffiness is often a sign of herniated orbital fat and surgical correction may be required. Dr. Durboraw is a board certified oculoplastic surgeon specializing in eyelid surgery. During your consulation, she will evaluate your condition fully and make recommendations tailored to your needs.
Topical Therapy using prescription-strength, clinically-studied products is essential for successfully treating lower eyelid problems. Many options are available: peptides act as growth factors to stimulate new collagen formation at the cellular level, hyaluronic acid-based topicals reduce the appearance of lines and wrinkles by thickening the top layers of the skin, and retinoid-based topicals enhance cellular turnover to improve the health and appearance of skin. At the Center for Aesthetics, we only prescribe state-of-the-art topicals that have been clinically studied and proven to be effective. Topical therapy is the key component to long term success no matter what else is prescribed and will make your results from any procedure more impressive and more long-lasting.
Ultherapy treatments may also be beneficial for lower eyelid collagen loss. Ultherapy uses ultrasound energy to visualize the collagen layers of your face before applying microscopic thermal injuries to that tissue. A full treatment of the lower face typically takes about 45 minutes, and collagen fiber contracture will take effect immediately. The astute patient may notice the feeling of skin tightening and subtle lifting immediately following their session. Complete results usually appear gradually over the course of about six months as your body creates new collagen fiber. Ultherapy is an in office treatment which does not require sedation or other oral medications. There is usually no downtime, although bruising can occur. Your Center for Aesthetics board-certified medical provider will make recommendations for future treatments based on your age and starting condition. Ultherapy does not remove fat and so is combined with CoolSculpting when both skin laxity and submental fat are present.
Lower Eyelid Blepharoplasty Surgery is recommended in cases where the lower eyelids have significant herniated orbital fat or excess eyelid skin, but is not appropriate for crepiness or wrinkles in the lower eyelid. Heredity and the aging process can lead to prolapse or bulging of the fat pockets cushioning the eyeball within the bony socket. These fat pockets can hang over the orbital rim, accentuating the tear trough and giving the patient a very tired appearance. Pinchable excess skin may also indicate the need for surgery. Insurance does not cover the costs of lower eyelid blepharoplasties, but sometimes this cosmetic surgery is performed at the same time as an insurance paying upper eyelid blepharoplasty. This procedure is done in an outpatient surgical setting under IV sedation, takes 1-2 hours, and patients are ready to go home within about 20 minutes of leaving the operating room. During the procedure an incision is made below the lash line, and the bulging fat pockets are contoured as necessary. Any excess skin is conservatively removed. Recovery is typically 2-3 weeks long, and mostly consists of bruising and swelling.