Am I A Good Candidate For A Pinch Lower Blepharoplasty?

Q: Dr. Eppley, I’m interested in a pinch lower blepharoplasty and am seeing if I am a candidate for the procedure. I took the picture smiling because the wrinkles aren’t as noticeable when I’m not smiling. I have seen a few plastic surgeons about my options. I do have a little fat under my eyes that I’ve been told could be fixed by filler or moving the fat around. That doesn’t bother me as much as the loose skin, and I’m hoping that tightening the skin will help. I will be fifty in November, but I lead a very healthy lifestyle with regular chemical peels. If I did the recommended procedures, what is the recovery time?

A: The difference between someone who needs a pinch lower blepharoplasty technique versus a full lower blepharoplasty is a function of numerous factors. How much loose skin is present, is there an orbicularis muscle roll, presence of any fat herniation and how much loose wrinkled skin do they have. In addition, the age of the patient and how much facial aging they have is also relevant…as pinch blepharoplasties are generally reserved for early signs of periorbital aging. (less than 50 years of age) Your picture is a smiling one so that obscures some of this anatomic information. But clearly you are young and do not have much herniated fat. Thus based on this one picture, I would say that a pinch blepharoplasty combined with a 35% TCA peel for the rest of the lower eyelids and 8 units of Botox for the orbicularis muscle activity per eye would be beneficial. You can’t get rid of all your lower eyelid wrinkles with any procedure, particularly when one smiles, but this would provide a major improvement with limited downtime. Expect one week or less of a ‘cosmetic’ recovery.