How we assess skin quality
In examination we look for:
- Elasticity — the "snap-back test": pulling the lower lid downward and seeing how quickly it returns to position
- Crepiness — fine wrinkles when relaxed (different from smile wrinkles)
- Pigmentation — sun damage, hereditary darkness, post-inflammatory changes
- Thickness — thin transparent skin shows underlying vasculature
- Scar history — keloid tendency, prior incisions and how they healed
How skin quality changes the surgical plan
Lower lid technique depends heavily on skin quality:
- Elastic skin (typically under 45, well-cared-for): transconjunctival with no skin removal
- Mild crepiness, good elasticity: transconjunctival + skin pinch
- Significant skin redundancy, fair elasticity: subciliary with conservative skin excision
- Heavy laxity, poor elasticity: subciliary + canthopexy support to prevent retraction
The wrong combination — significant skin laxity treated with transconjunctival only, or thin elastic skin treated with subciliary — produces unsatisfactory results regardless of technical skill.
Frequently asked questions
Can I improve skin quality before surgery?
Modestly. 3–6 months of consistent sun protection, topical retinoid, and good hydration improves skin condition slightly. Significant existing damage doesn't reverse but can be stabilised.
Does laser before surgery help?
Fractional or resurfacing laser improves skin quality and can be considered 4–6 months pre-operatively. After bleph, laser can be added at 6 months if residual crepiness is the remaining concern.
Not sure if you're a candidate?
Blepharoplasty is most successful when patient anatomy, age, and goals align with what surgery can realistically deliver. Send three facial photos (front, profile, eyes-closed) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you commit to anything.
Ready to discuss your case?
Doç. Dr. Erdal personally reviews every enquiry. Honest assessment of whether blepharoplasty is right for you, with no pressure to book.