Since my midface surgery, the skin in my lower eyelid bunches up when I smile. What is going on and what can I do about this?
The midface anatomy is highly complex. Several of the midface tissue planes act as glide planes. Certain midface and lower eyelid treatments seem to change the nature of how these tissues glide over each other. CO2 laser resurfacing can be associated with aggressive contraction of the glide planes of the lower eyelid resulting in bunching of the lower eyelid skin with smiling. Interestingly, this type of effect is not typically seen with a chemical peel that produces a comparable degree of tightening. This type of skin heaping can be seen following midface lifting which may stimulate an inflammatory response in these same glide planes. The best cure of this issue is to avoid overly aggressive skin and midface lift procedures.
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- Since my midface surgery, the skin in my lower eyelid bunches up when I smile. What is going one and what can I do about this?