Improving the way your eyes look


The eyes are often described as “windows to the soul” but they can also outwardly reflect health and vitality. Unfortunately, however, the delicate skin surrounding the eyes is often one of the first areas to show signs of premature aging.  Cosmetic eyelid surgery, also called blepharoplasty, ranks third among the most common cosmetic surgical procedures for men in the U.S. according to the American Society for Aesthetic Plastic Surgery.  Patients often desire a more “rested” or youthful appearance to gain an edge in a competitive job market or to simply improve upon years of sun damage, expression lines, loss of tissue volume due to the normal aging process or inherited traits such as undereye bags. Often, it is the inherited traits that prompt patients to seek treatment even in their 20’s or 30’s. There are a number of factors that contribute to the common complaints about the eyes and a thorough medical history and examination findings will relate to the recommended course of action.  Without addressing underlying medical conditions which can affect the appearance of the eyes, such as allergies, sinusitis, dry eyes and thyroid problems, most corrective treatments may be temporary at best. In addition, lifestyle measures, such a quitting smoking and wearing sunscreen, are necessary to achieve the best results.
So, what are some of the options available to help attain that rested, youthful and healthy appearance? Generally, patients first seek treatment in the form of an eye cream designed and marketed to address their specific concerns.  While some ingredients such as retinol have been clinically shown to increase collagen, help maintain elasticity and lighten dark spots, most eye creams can provide only temporary and slight improvement in the eye area. For example, caffeine is a common ingredient in eye creams as its diuretic properties help to temporarily “de-puff” the eye area. Topical vitamin K, peptides and antioxidants may also have some benefit on lightening dark circles, minimizing fine lines and reducing inflammation, however, clinical studies are limited and more research is needed to determine the extent of their usefulness. Adequate rest, consistent use of sunscreen, avoiding squinting by wearing sunglasses and corrective lenses if needed,  avoiding smoking and known allergens, as well as, a healthful diet seem to be the best non-procedural treatment options for patients.  And, avoid rubbing or touching the skin around the eyes which can traumatize the delicate tissues and increase the likelihood of irritation, darkening, and fine lines (lichenification).
For those patients who are not satisfied with eye creams and lifestyle measures, there are a number of cosmetic procedures which can help improve the eye area.  Botox is the most commonly performed non-surgical procedure and is very effective at diminishing crow’s feet—the fine lines and wrinkles surrounding the eye area. Botox is a quick, safe and minimally invasive procedure with results lasting up to 3 months. Botox can be combined with other treatments when addressing multiple concerns about the eye area.
Lasers are also an excellent non-surgical option for tightening the skin around the eyes, reducing lines, wrinkles and dark spots. Newer lasers allow for less downtime and more specific targeting of areas of concern. Lasers also improve skin tone and texture and stimulate new collagen formation for long-lasting results.
With aging, the lower eyelids may also show a deflation or loss of tissue volume resulting in a gaunt look or circles under the eyes. The deflated area may be filled using fat grafting or a facial filler to create a more youthful and rested appearance. This procedure can also help minimize the look of dark circles by lessening the depression between the “bags” and the cheek skin.
Many patients have upper or lower eyelid laxity and bags from fat herniation.  Blepharoplasty surgery can be performed to correct these common complaints resulting in a brighter, more alert and rested appearance. Incisions follow the natural contour of the eyelids or may be placed inside the lower eyelid and are well-camouflaged when healed. Eyelid surgery can be comfortably performed with local anesthesia and mild oral sedation on an outpatient basis.  While any surgical procedure carries some risks; bruising, mild swelling, dryness and a short-lived tightness or soreness around the eyes are the most common side effects.  Most patients can return to work within a few days to a week and are quite satisfied with results. This procedure combined with fillers and Botox is very effective in giving a natural, yet improved appearance to the skin around the eyes.
Do your research, and don't fall for marketing. Talk to your surgeon and even interview a few surgeons, before choosing one. With careful evaluation, well-thought out interventions and realistic expectations there is a great deal that can done to improve the aging process and achieve that much sought after rested and youthful appearance.
Article by
Chicago Dermatologic Surgeon