There are close to a thousand famous quotes about the eyes. Shakespeare wrote about the eyes being “the windows to the soul” while Thoreau thought that they were “the jewel of the body”. But both understood that our eyes, as a direct reflection of our emotions, are probably the most important feature on the face. They are also the most identifiable. Think about when you meet someone new. You shake that person’s hand while looking into his or her eyes. It’s a sign of respect. But it’s also an opportunity to get to “know” that person. The eyes are a vital part of not just your identity, but they also help create connections. So, whether you are meeting a new client, friend or potential love interest, your eyes may make or break the deal.
This is why it is so important that your eyes reflect how you feel on the inside. Since the skin around our eyes is not just incredibly thin and delicate, but also moving constantly, the eyes are typically the first feature on the face to show the earliest signs of aging. This may manifest as:
- Wrinkles on the outer edge or crow’s feet
- Under eye bags
- Droopy upper lids
- Hanging skin on upper outer corner that may impair vision
- Dark circles under the eyes
Furthermore, aging eyes, unlike other facial aging, is something that affects both men and women equally. There are a number of different ways to rejuvenate the eyes. The right procedure for you is really going to depend on your needs and tolerance for downtime. Having said that, eyelid surgery or blepharoplasty is one of the simplest surgical procedures with an extremely fast recovery. This is why it is often the “gateway” surgical procedure for many of my patients.
Is Eyelid Surgery Right for You?
Deciding whether or not to have surgery is a big deal. You want to feel confident in your decision. First of all, when you look in the mirror, do you find that your eyes reflect your age? Most of the time when a patient comes in to see me for a blepharoplasty consultation, it is because there is a disconnect between how old he or she looks on the outside versus how young the patient feels on the inside. My job is to help get your inner and outer self-more in-synch.
Non-Surgical Procedure for the Eyes
In most cases, the very earliest signs of aging in the eyes can be treated with non-surgical modalities. For example, the fine lines and wrinkles that tend to appear on the outside corner of your eyes when you smile (often referred to as crow’s feet) respond really well to Botox®. This injectable works by actually relaxing the underlying “dynamic” muscle that is causing the wrinkle. The upside to the procedure is that it is a fast, effective method for smoothing out wrinkles with no recovery time. The downside is that since Botox® is not permanent, you are going to need to continue to get injections every 3-4 months in order to maintain your results.
Fillers are another great option to rejuvenate the eyes for some patients. I will often use a bit of filler on the temples to produce a slight “lift” to the upper lid. This can be a really effective means for opening up eyes that have begun to sag or droop with age. It works particularly well when combined with Botox® for the crow’s feet. The other hot spot for fillers is under the eyes. While dark circles can be genetic, they can also result from a displacement of fat under the eyes and a stretching of that very thin skin. Properly placed filler can restore some of this lost volume, reducing the shadowing appearance of dark circles. Other options for treating aging issues on the lower eyelid non-surgically are a chemical peel or a laser treatment. However, any non-surgical modality only works for mild to moderate signs of aging. A severe amount of excess skin in the upper lids or pronounced under eye bag are going to need a surgical intervention.
Anytime that there is enough loose skin to cause a droop or fold in the upper eyelid, this will need to be excised surgically. An upper blepharoplasty is a simple procedure in which I trim away excess skin. Typically performed in a procedure room in the office under local anesthesia, the incisions are placed in the crease of the eye where any subsequent scar will be undetectable. These sutures will need to be removed 7 days after surgery. You can expect some slight bruising and swelling, but most patients are back to their daily routine at 10-14 days post surgery.
A lower blepharoplasty may be more complex and can require slightly more downtime. Some patients, especially men, suffer from a fat pad that has moved or migrated as the skin beneath the eyes has thinned with time. For these patients, I use what’s called a trans-conjunctival approach in which I make an incision on the inside of the lower eyelid through which I manipulate and/or remove part of the fat pad that is causing the patient’s under eye puffiness. I will often combine this with a minor under eye skin excision (aka a “pinch excision”). The results are seriously dramatic. In general, eyelid surgery is one of those procedures that delivers excellent ROI or return on investment. You give up about two weeks of looking a little swollen for eyes that appear a decade younger. And when your eyes look brighter, you just feel better.