The under eye ‘crepiness’ of skin is annoying and ageing; it is usually caused by excess poor quality skin, mostly through over indulgence of the sun; it is further made worse with discolouration and wrinkles. sometimes, it can be the results of post surgical removal of large ‘eyebags’ when the poor quality under eye skin fails to retract.
1) Laser surgical removal of excess skin and Fraxel laser resurfacing and tightening of skin.
2) Non-surgical tightening of skin with Thermage.
3) Fraxel laser takes care of discolouration of skin, including dark circles.
Surgical excision of excess under eye skin is reserved for severe crepiness of skin; this has to be done very accurately under microscope, with no eyelids pulling down effect, no concavity look. This can only be achieved with skill and experience. It is important to preserve the function of the eyelids as well as the aesthetic aspect. Ideally, there must be no scleral show meaning that there should be no change in the eye shape and the cornea should be in contact with the border of lower eyelids on recovery, that is how the natural eyes should look.
Like most surgical procedures, initially, there may be eyelids pulling down effect and there may be overflow of tears. As long as the amount of skin that is measured and removed accurately, the good recovery will take place with confidence.
It is extremely important to warn patients not to smoke a month before and during recovery as smoking compromises the circulation, hence the healing process and the wound breaking down.