“I look tired” is one of the most frequent complaints we hear from patients. Or alternately stated,“people ask me if I’m tired” or “my eyes look tired.” When we look at another person, we normally look at their eyes first. So, having the eyes appear youthful and bright is one of the most important items we address in Plastic Surgery. Truly, the eyes have it. Fortunately, our technology to maintain and rejuvenate the eyelids and surrounding area has improved a lot over time with both surgical and non-surgical methods.
What makes the eyes age? Many factors influence how our eyes change with time. One of the most important is our genes. We not only look like our parents, but we age like them too. Aged appearance of the eye occurs because of changes in the skin of the eyelid and surrounding area, changes in the fat compartments inside the eye socket and the area around it, and muscle activity.
One of the earliest changes is the development of wrinkles around the eyes, known as “crow’s feet.” By far, the most popular treatment for this area is a neuromodulator, such as Botox® or Dysport®. Neuromodulators work by decreasing muscle activity so that the muscle does not fold the skin and create wrinkles. Deeper wrinkles in the crow’s feet area and eyelids themselves may benefit from skin resurfacing by a chemical peel or laser.
The eyelid skin is the thinnest skin in the entire body and it is very prone to wrinkling. Thus, it is extremely important to keep this skin as youthful and plump as possible. Numerous advances in skin care have helped with treatment of this important area. The affiliated Aesthetic Skin Care Center LLC, practice located in our office provides guidance selecting and using pharmaceutical grade products to help minimize existing wrinkles and prevent new ones.
Development of excess eyelid skin is the hallmark of a tired looking eye. A surgical procedure known as blepharoplasty remains one of the most useful and simple procedures to make you look younger, brighter, and refreshed. The goal of surgery, always, is to look more youthful, but still look like you.
For the upper eyelids, blepharoplasty involves removal of extra skin, muscle, and fat. The scar is positioned along the upper eyelid crease. After surgery, patients will frequently comment that the operation “opened my eyes.” Some patients will also benefit from lifting the brow at the same time. Here again, technology helps us with the availability of an endoscopic brow lift which accomplishes the desired effect using only a few small incisions in the scalp.
The lower eyelids tend to develop wrinkled extra skin, puffy fat pads, a tear trough crease (the oblique line which extends downward from the eye), and sometimes a hollow appearance. As with the upper eyelid, the only treatment for excess skin and puffiness is surgery. The incision is usually placed just below the eyelashes. Changes in the amount of fat in the lower eyelid and upper cheek probably have the most significant impact on the appearance of the lower eyelid area. While traditional lower blepharoplasty procedures focused on simple removal of fat from the eyelid, modern procedures focus on redistribution of fat and maintenance of volume to avoid a hollow, aged look. Fat may be moved from an area of excess, such as a puffy eyelid, downward to decrease a deep tear trough. The area underneath the eyelid may also be restored simultaneously with transfer of fat from some other body area (fat grafting) or with a dermal filler such as Restylane®, Juvederm®, Lyft®, Voluma®, or others. The goals are to smooth the eyelid and blend the transition from the eyelid to the cheek as seamlessly as possible into a youthful contour.
Fat may be moved from an area of excess, such as a puffy eyelid, downward to decrease a deep tear trough. The area underneath the eyelid may also be restored simultaneously with transfer of fat from some other body area (fat grafting) or with a dermal filler such as Restylane®, Juvederm®, Lyft®, Voluma®, or others. The goals are to smooth the eyelid and blend the transition from the eyelid to the cheek as seamlessly as possible into a youthful contour.
If you look in the mirror and think you look tired, remember, the eyes have it – as the most important place to begin rejuvenation.