Reverse Aging in the Eye Area

Arnold Zweig, MD

Article by
Atlanta Facial Plastic Surgeon

Many people have droopy, upper lids and /or baggy lower lids with excess skin as well as “crow’s feet” and wrinkles. Blepharoplasty (eyelid surgery) is amazingly effective to remove bags and extra skin. It is virtually painless, has little downtime, and is cost-effective with long-lasting results.

Some physicians and patients think a browlift should be used to remove excess upper eyelid skin or to improve the frown lines in the glabella (between the eyes). There are some patients who do need both a browlift and upper blepharoplasty, however if used inappropriately, a browlift gives the patient a startled expression by raising the brows to an unnatural position. There are also side effects such as a raised hairline and/or hair loss and numbness therefore a browlift should be used primarily to lift brows that are too low.

Sometimes in addition to the browlift or upper blepharoplasty, it is recommended that the muscle between the eyes is altered to eliminate the frown line. The risk of doing this is that there is a chance that cutting or altering this muscle will leave a space or a ridge that must be filled with a temporary filler such as Juvederm or Restylane. Assuming that the patients' eyebrows are not too low, the most effective and least invasive procedure to achieve the result the patient desires is to have upper eyelid surgery to remove the excess skin and Botox to improve or eliminate the frown lines.

Some patients may have one eyebrow higher than the other or a lack of space between the eyebrow and lashes. For a simple cure without surgery, I often suggest that our esthetician remove some hair below the brow creating more space. The eyebrow that is lower can be “raised” by our permanent make-up artist by applying color above it and matching it to the higher brow.

Surgery, unfortunately, does not cure fine lines and “crow’s feet". These lines are best helped with chemical peels, laser treatments, Botox, and/or an injectable filler such as Juvederm. These are great options for patients who are not quite ready for surgery or do not need surgery. Chemical peels or laser resurfacing along with our skincare routine improves fine lines and wrinkles.

Due to the cost and healing time of laser, which is the most effective procedure, many patients opt for a chemical peel to treat the lower eye area. Botox is also fantastic in this area as it prevents the cheeks from moving upwards. Treating the lasered or peeled areas with Botox prevents the reformation of lines. Botox treatments for frown lines are also extremely effective and gets better the longer the patient maintains the treatments. If the lines are very deep, I use a combination of “techniques”, filling the lines with an injectable filler and injecting the muscle with Botox. It is not uncommon for the frown lines to be completely eradicated with this treatment.

I always strive to find the best solution for each patients' eye area using the safest and most conservative approach to achieve a more youthful, less tired, and natural appearing result.