What can I do to correct the loose skin around my eyes?

As we age, the skin above the eyelids can lose elasticity and loosen, causing what is known as “skin redundancy” or dermatochalasis. This excess skin can cause heaviness and drooping of the eye tissue. In addition, fat may gather around the eyes, causing even more heaviness.

For many people this natural drooping and excess fat is solely a cosmetic concern. For others it results in lateral hooding of the eyes, which can cause vision problems and a reduction in the visual field. It may also interfere with the ability to comfortably wear glasses or contacts. When this is the case for my patients, I send them first to an ophthalmologist for visual field testing to rule out any eye conditions and to determine the degree of visual impairment and medical necessity for surgery.

The corrective procedure is called upper eyelid blepharoplasty. An incision is made within the natural crease of the eyelid so that any scars will be easily concealed in the eye’s existing fold. Through the incision, the surgeon can remove excess skin and remove or reposition fat deposits, and may tighten muscles.

There will be some initial swelling and bruising, typically lasting about a week as the tissues heal. Most of the results will be visible within a few weeks, with even more improvement seen within a year. Occasionally, further aging will result in the need for follow-up surgery years later, but typically once a blepharoplasty is performed the results are long-lasting.

It is important to have a thorough evaluation by a board certified surgeon who specializes in the procedure. Sometimes the appearance of drooping eyelids is instead caused by ptosis (an abnormal position of the margin of the eyelid) or brow ptosis (a sagging of the upper brow that weighs down on the eyes), conditions that require different treatments. There are also surgical procedures for bagginess of the lower eye area (called senile entropion). Typically this is a cosmetic issue, but in some cases it can result in excess exposure of the eyeball causing irritation severe enough to require lower eyelid blepharoplasty for functional reasons.

While you can’t control your genetic predisposition, which is a factor in how much your eyelid tissue will sag, there are some steps you can take to help prevent the need for blepharoplasty. Protecting your eyes from the sun is the key. The skin on the eyelids is the thinnest skin on the body, and very susceptible to damage — so use hats and sunglasses. Keep any allergies under control, try not to squint or rub your eyes, and if you have dry eyes keep them lubricated.

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Dr. Andrew Ordon is a board-certified surgeon in the areas of aesthetic, plastic and reconstructive surgery and co-host of the Emmy®-nominated syndicated series, The Doctors. He is a proud, founding member of the Surgical Friends Foundation that offers complimentary reconstructive surgery around the world to those who cannot afford medical treatment. Many of these patients suffer from birth defects, physical abuse and burns, among other adverse conditions.