What should I do about sagging skin under the eyes?

As we age, everyone inevitably bears the visible signs of time—and facial wrinkles are among them. What can be done about sagging skin under the eyes?

What Can Be Done About Sagging Lower Eyelids?

Sagging of the lower eyelids can be improved through surgical procedures such as a transconjunctival blepharoplasty (“inner lift”) or a thread lift. These techniques help tighten loose skin and correct mild to moderate lower eyelid ptosis (drooping). For some patients with significant hollowing or volume loss in the lower eyelid region, hyaluronic acid injections or autologous fat grafting may also be considered. Such volume-replacement treatments not only restore contour to the hollowed area but can simultaneously improve mild skin laxity. Therefore, when addressing lower eyelid ptosis, an individualized assessment is essential—treatment must be tailored to each patient’s specific anatomical features and degree of aging to achieve optimal surgical outcomes.

The primary cause of lower eyelid laxity is age-related degenerative changes—hence this condition is most commonly observed in older adults. With advancing age, the orbicularis oculi muscle gradually weakens, leading to loosening of both the eyelid skin and its supporting ligaments. As a result, the eyelid skin loses its normal adherence to the underlying globe.

Gravitational forces further contribute to progressive lower eyelid skin laxity; in severe cases, this may lead to ectropion (outward turning of the eyelid margin). When symptoms are mild, no intervention is typically required. However, if ectropion develops—especially if it impairs eyelid closure during blinking or sleeping—surgical correction should be considered. We hope this information has been helpful!