Blepharoplasty is a surgical procedure that corrects sagging or baggy eyelids due to aging, injury, or a medical condition. Because this procedure requires local or general anesthesia coupled with surgical incisions, you may find you are not yet ready for blepharoplasty. That’s okay — there are alternatives to tighten the skin around your eyelids. Here are some potential alternatives to blepharoplasty.

Laser Skin Resurfacing

Laser skin resurfacing involves applying a laser to the skin around your eyes to stimulate collagen production. Loss or damage to your collagen fibers is what can cause eyelid sagging in the first place, which is why laser skin resurfacing may be an option. This approach can be especially beneficial if you have signs of sun damage such as skin discolorations around your eyes because laser skin resurfacing can reverse the effects of aging and sun damage.

The procedure is not invasive, but may take several sessions for you to experience results. Also, if you experience severe eyelid drooping, laser skin resurfacing may not provide as dramatic a difference as blepharoplasty can.


Thermage is a blepharoplasty alternative that involves transmitting radiofrequency waves to your skin. These waves can help to smooth and tighten the skin underneath your eyes or on your eyelids. Thermage can be applied on the eyes, face, stomach, arms, hands, thighs and buttocks. Like laser skin resurfacing, Thermage is a non-invasive procedure. The waves penetrate to the deeper layers of your skin and stimulate collagen production. When new fibers have had time to grow, the area around your eyelids can appear tighter and smoother.

Results are often seen after the first treatment, although you may require additional treatments to achieve your desired results. The procedure is considered effective for all skin types while some laser resurfacing may not be proper for different skin types and tones.

Botox® Cosmetic

Botox cosmetic is a form of botulinum toxin, which works to temporarily paralyze the muscles that contract and create wrinkles. A plastic surgeon can inject Botox into the area around your eyes, making the skin appear smoother and less wrinkled. Botox is most effective in areas where your skin folds due to movement, such as crow’s feet. If you are concerned about having baggy under-eye skin, your plastic surgeon may recommend a combination approach of using Botox and fillers.

Botox’s effects typically last for four months, which means you may require more frequent trips to your surgeon’s office. However, the injections can take as little as 15 minutes and require very little downtime for recovery.

Dermal Fillers

A variety of dermal fillers are on the market today, helping to add volume to areas where your skin may appear deflated or “baggy.”

“Using fillers can be much like sculpting a face,” says Constance Barone, MD, FACS, a plastic surgeon at The Medical Day Spa & Laser Center in San Antonio, Tex. “This instance is where an experienced injector comes into place, and it’s important to consider the artistry of the surgeon when choosing a provider.”

Examples of fillers available on the market include Restylane, Juvederm, Radiesse, Perlane, Prevelle Silk and Evolence. The length of time each filler lasts depends upon the individual brand and your skin quality.

Making The Decision

To determine the best options for you, John T. Alexander, MD, a San Diego, Calif.-based plastic surgeon at Alexander Cosmetic Surgery, recommends seeing a plastic surgeon who offers a variety of services from laser skin resurfacing to Botox and dermal fillers to surgical options. This allows your surgeon to truly evaluate your skin and appearance and what options are available to you.

“Patients can go throughout their twenties without seeing significant changes, and then almost overnight start to notice wrinkles,” Dr. Alexander says. “If you start having minor procedures, such as dermal fillers, in your thirties and forties, you can keep your skin in good condition that can extend the time before you may need an invasive procedure.”