One of the areas of the face that can show the earliest signs of aging is the upper and lower eyelids. You may have an upper lid that is just beginning to sag or look hooded, or a lower lid developing slight bagginess, uneven pigmentation that appears, or pronounced creases on the outer corners as you smile (they are graciously called "smile lines or crinkles). Depending on how you feel about aging, your professional look, or the recent economic trend, which may be forcing you out into the new workforce looking for a job, you may be unhappy with this aging look. Obviously there are now new creams, lotions and potions as well as laser technologies that claim to address wrinkles and facial aging. With surgery still considered the gold standard for significant wrinkles and other aging issues, how do you decide when to opt for everything but surgery and when is it really time to go under the knife?
It’s important to understand that there is typically a window of time, when you can turn to less invasive treatments that may help to diminish wrinkles and age spots or pigmentation associated with aging. Having realistic goals, which tends to include the realization that you may simply be delaying the inevitable surgery, has to be part of the equation. It’s also important to realize when wrinkles are just too deep or changes in skin’s elasticity cannot be helped significantly by anything less than surgery. Plastic surgeons and dermatologists will concede that in your 40s (unless you are an unusual case) is a good time to turn to retinoids like Renova and Retin A, which have been proven to stimulate collagen and improve cell turn over. Used daily, these creams or lotions, which are prescription grade, can slow fine lines from developing and improve pigmentation issues. The next significant level of treatment for eye rejuvenation would be laser resurfacing.
Fraxel is a type of fractional laser that burns tiny holes in the skin in order to stimulate collagen synthesis and repair. The healing process can cause a tightening of the skin, lines get softer and recuperation or down time is quite minimal. Patients often have pink skin or slight redness in the areas targeted, and usually more than one laser treatment or a series is needed for best results. Results occur over time. Regular laser resurfacing is a different approach that destroys the entire outer skin layers of the treated area, requiring up to a week, sometimes longer, before skin is fully recovered. It is a more aggressive approach to wrinkle and pigmentation relief and only requires one single treatment of the area(s).
A somewhat newer version of fractional laser involves the use of carbon dioxide, which literally vaporizes points in the skin, leading to significantly more regeneration of tissue when the healing occurs. Downtime is still minimal and camouflage makeup is rarely needed. Again, you will more than likely need a series of treatments. Doctors caution that with the fractional laser approach you may get less effective results, because you are not treating the entire surface area. Indeed if you are gun shy about surgery these approaches can buy you some significant time. If however, you have significant pigmentation issues and deeper wrinkles and a hooded lid, you may want to consider having the surgery, allowing newer operative techniques to work their wrinkle erasing magic.
Updated August 1, 2011