Every now and then, a patient turns poet while consulting with me. It’s invariably to recite that old adage about the eyes being the window to the soul, followed by the puzzled complaint that "my eyes don’t look the same anymore."
Although you may feel that your eyes have become smaller and differently-shaped, it’s actually not the windows (your eyes) that have changed, but the area of your face that frames them known medically as the periorbital region. This is due to three cardinal aspects of the aging process - volume loss, loss of skin elasticity, and muscle hyperactivity - which cause you to develop under-eye bags and hollows, crow’s feet and sagging of your eyelids and eyebrows.
Aging around the eyes is insidious" and it’s also counter-intuitive. If you’ve noticed bags under your eyes, it might seem obvious to you that the solution would be to remove those bags surgically with a blepharoplasty. However, this can actually worsen the situation, as can pulling sinking eyebrows and eyelids upwards and outwards with a face lift, by exacerbating the effects of volume loss. The resultant flattened cheeks and hollows under your eyes actually make you look "done", rather than younger. Another issue is that Botox treatment plays a pivotal role in rejuvenating the eyes, yet some patients fear that Botox will leave them with a "frozen face" or cause other problems. In fact, Botox treatment for wrinkles has a long track record of safety and gives completely natural results when treatment is performed by an expert (you can find an expert near you by visiting www.botoxcosmetic.com, an informational web site set up by Allergan, the company that manufactures Botox).
Your eyes are such a focal point of your face that restoring them to magnificence makes a tremendous improvement to your overall appearance. Today’s minimally invasive techniques are suitable for anyone whose eyes need a quick pick-me-up. If you have very droopy eyelids, you may also require surgery, but volume replacement with fillers, muscle relaxation with Botox and new laser treatments are still a vital part of your treatment plan, to give you the most natural-looking and long lasting results.
The filling of bags and hollows under your eyes is best done by gentle injection of a filler such as Restylane or Juvederm. These fillers contain hyaluronic acid, the sugar-based substance that is naturally present in your skin and is lost as you age. With expert technique and a little numbing cream, you will barely feel the injections and usually have only a little swelling or pinpoint bruising for about a week after treatment.
This can be covered with make-up (I apply Colorescience medical grade mineral make-up to my patients after treatment, so that they can return to regular activities immediately). Expert technique gives smooth results and also stimulates your skin to produce its own collagen, which makes your results last longer - for some of my patients, as long as eighteen months or more. It’s actually an advantage that Restylane and Juvederm treatments are not permanent, as they can be adjusted with time to match your facial contours as you continue to age.
There’s a saying among cosmetic surgeons that permanent fillers produce permanent problems. I’ve seen this in a number of patients who’ve been injected with permanent fillers such silicone and Artefill and ended up developing disfiguring lumps and bumps that last for years or even forever.
Muscle Relaxing is done with Botox. Tiny amounts are injected in an individualized pattern just beneath the surface of your skin to relax overactive muscles, smoothing out crow’s feet and other wrinkles around the eyes. An expert cosmetic surgeon can also use Botox to restore an elegant, youthful arch to your eyebrows and to offset age-related sagging of your eyelids.
The best Botox is undetectable; it looks completely natural and there is no hint of "face freeze." In fact, many celebrities who are criticized for being over-Botoxed are actually the victims of over-zealous brow lifts or other invasive surgery. Botox is approved by the FDA for treatment of the frown lines between your eyebrows. Smoothing of crow’s feet and eyebrow arching with Botox are popular "off-label" treatments.
Fractional laser resurfacing is an innovative technology that has replaced old-style laser treatments that were painful and broke down the upper skin layer, causing a couple of weeks of healing time, followed by skin redness for several months. New fractional lasers improve wrinkles, and stimulate your skin to tighten itself and produce new collagen with minimal recovery time. A couple of laser systems worth checking out are Palomar’s two StarLux lasers, the Lux 1540 and Lux 2940, and Reliant’s three Fraxel lasers, Refine, Restore and Repair.)
The type and amount of laser energy that is delivered to your skin can be adjusted to precisely address your own unique pattern and extent of aging. You can expect pinkness and mild swelling of your skin for one to six days, depending on the type of laser that was used. My patients use Colorescience, a medical-grade mineral make-up, to naturally hide this pinkness and any temporary injection marks or tiny bruises from Restylane or Juvederm treatment.
Eyebrow and lash tinting and Xtreme Lashes Eyelash Extensions can also be of immense help in rejuvenating your eyes and defining their frame.
Our literature through the ages is filled with lyrical tributes to the eyes. Though I’ve yet to read any praise for eyelids, I do receive plenty of appreciation from my patients when I’ve restored that all-important frame to their eyes and made them "look like myself again." Perhaps our poets were wrong: it is not your eyes that have it, but your eyelids