Eye Rejuvenation
They say the eyes are the windows of the soul, and we know that when we speak to each other, we look at two main places: the eyes and mouth area. Therefore, it’s imperative to have bright, youthful-looking eyes. While eyelid rejuvenation is complicated, it is also something surgeons and cosmetic physicians have mastered.
The approach to eye rejuvenation is broad and involves both surgical and non-invasive strategies. The eyelid that surrounds the orbit has intricate anatomy, which involves skin, muscle, fat, and bone. As we age, all the tissues in this area change their structure and are interrelated.
For example, due to ultraviolet radiation, our skin gets thinner because of collagen loss and begins to wrinkle. But underneath these wrinkles, the bone structure also changes with age, which makes the eyes look more sunken and hollow. Therefore, there is an intricate interplay between skin, muscle, and bone as our face ages and this makes our eyes look older and less youthful.
The eyelid skin is the thinnest on the body. Therefore, it is extra vulnerable to ultraviolet radiation damage which results in dermal thinning. First, as the skin thins, wrinkles appear in the lower eyelid, particularly because the muscles in this area continue to contract and animate when we speak, laugh, squint, or even read. Muscle movement causes the skin to crease and wrinkle especially since the eyelid skin is thin.
Using sunscreen and avoiding sun exposure is the first thing we can do to prevent eyelid wrinkles. The second tactic is to use a collagen-boosting eyelid cream. Your provider can recommend the best one for your skin type.
A third, and very important strategy, is using neuromodulators (i.e Botox, Xeomin, Dysport or Daxxify) to prevent continued muscle contraction and skin creasing. Small injections of botulinum toxin can be used in the muscles around the eye to weaken muscle contractions, eliminating the skin’s ability to crease and form a wrinkle. Neuromodulators can prevent wrinkles and should be started before you start to see wrinkles in the lower eyelids. Even if wrinkles have already started to form, consistent use of neuromodulators will prevent the wrinkles from becoming deeper.
The upper eyelid is commonly prone to overhanging or droopy skin. This can be genetic or environmental and begins to appear in your mid to late forties. It also can be due to genetics and inherited features.
Eyelid droopiness can be fixed non-invasively with procedures like Thermage® or a fractionated CO2 laser to tighten the eyelid skin. These procedures should be done early to tighten the upper eyelid skin and prevent sagging. If the eyelid drooping is severe, you might be a good candidate for an upper eyelid blepharoplasty. This is a surgical procedure that removes the excess skin with a thin incision along the eyelid crease. Both surgical and non-invasive procedures can improve the upper eyelid tissue.
At times, a droopy eyelid can be a result of a heavy or drooping brow. In this situation, another procedure called a brow lift may be indicated. An experienced cosmetic surgeon can evaluate your eyelid anatomy and guide you toward the right procedure.
The tear troughs are a complicated anatomical unit involving the upper cheek and lower eyelid. The eyelid-cheek junction involves bones, tendons, muscles, and fat. This area should be analyzed by a physician or surgeon who can fully understand the problem at hand.
Hollowness in the tear trough area can be due to a descended fat pad in the cheek, receded fat pads in the orbit, or looseness of the muscle around the orbit. This area may look hollow for many reasons, so jumping right to dermal fillers is not always the answer. Dermal fillers may be an easy solution for some early forms of eyelid hollowness in the right candidate. Lower eyelid surgery is another option for those that have either fat herniation, or bags under their eyes, or other forms of volume loss causing structural changes around the eye.
Tear trough hollowness and lower eyelid rejuvenation first involve a thorough evaluation from a trained specialist who can steer you in the right direction. Often, people jump to the easiest or quickest procedure, like filler, which can lead to even more eyelid puffiness if the true underlying issue is not addressed.
Similar to tear trough hollowness, dark circles are more than the color of your skin. Dark circles are due to three factors: the genetics of your skin (some people have darker skin pigmentation in some areas), hollowness due to fat pad distribution and bony changes, and skin thinness that reveals underlying blood vessels which give the skin a blue or darker hue. Dark circles are a complex, multifactorial issue.
There is no cream that can correct dark circles besides makeup concealer that hides them. Dark circles are not always due to aging; even some children have dark circles due to their genetics and anatomy. It is important to have your dark circles evaluated by a specialist who can recommend the best treatment. Skin lightening, lasers for visible vessels that reflect a blue hue, or filler can improve dark circles but the approach must be targeting the specific issue at hand.
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Lorraine Grassmann
OFFICE Manager
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(Extended hours by appointment only)
Lorraine Grassmann
OFFICE Manager
949-200-8222
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