The Surgeon Minute

Procedures to Rejuvenate Aging Eyes

Procedures to Rejuvenate Aging Eyes

Every waking moment of every day the muscles and skin around your eyes are hard at work. Whether your eyes are relaying an expression, squinting to block out the sun, or simply blinking, the skin and tissues are moving, creasing and changing. Constant motion and thin skin mean the eyes are one of the first places to reveal signs of aging on the face. By the time those signs of aging progress to heavy, sagging eyelids and loose skin and bags under the eyes, no amount of sleep can restore a well-rested look to the face.

Fortunately, there are cosmetic and surgical procedures available to improve and reverse aging concerns around the eyes. Patients should not, however, trust their eyes to just anyone, cautions board certified plastic surgeon Dr. Anup Patel .

Procedures to Rejuvenate the Eyes:

  • Upper Blepharoplasty
  • Lower Blepharoplasty
  • Browlift
  • Fat & Filler Injections

“When you pick a surgeon for eyelid surgeryn you need to make sure that the surgeon can deliver the results,” emphasizes Patel. “The eyelid has very complex anatomy and the eyes are one of the most distinct features of the face. You have to find someone that is extremely skilled and knows the anatomy, otherwise you’re going to have big problems.”

Aging in the Upper Eyelids

In the upper eyelids, excess skin can drape and cause what is referred to by surgeons as hooding. Over time, the heavy lid and extra skin may progress to the point where it becomes difficult to raise the eyelids or see clearly. Even very mild hooding can make a person appear tired all the time.

Surgery to remove excess skin in the upper eyelids is called an upper eyelid blepharoplasty. When a patient is a candidate for an upper lid blepharoplasty, the first thing Dr. Patel takes into consideration is the position of their brow. “One of the biggest mistakes people make is they forget to look at the brow position,” shares Patel. “They take out the skin and the patient comes back to their clinic, and all of the sudden the brow is even lower.”

When the brow is properly considered before surgery, it can be addressed at the same time as the eyes if necessary. This, points out Patel, will provide the patient with an overall rejuvenated appearance to the entire eye area.

Sometimes surgery to the upper eyelid involves more than just removal of skin. If the eyelid is drooping as well as sagging, it may be the result of how the muscles of the eyelid have aged and changed. Small sutures may be necessary to help reposition the muscles to a more youthful position.

Aging in the Lower Eyelids

A telltale sign of aging in the lower eyelids is a distinct separation between the under eye area and the cheek area. In youth, the two areas blend seamlessly together. As the face ages, fatty tissue in the cheeks begins to shift downward. At the same time, the fatty tissue around the eyes that protects the eyeball begins to push outward through the tissues that hold them in. The result is visible bulges of fat that are look like bags under the eyes.

The surgical procedure that addresses the lower eyelid areas is called a lower eyelid blepharoplasty.  Dr. Patel places an incision inside the lower eyelid, where it is not visible after surgery. Through the incision he is able to locate the pads of fat that are pushing outward, removing or repositioning them. Next, he uses a special tool to smooth out the junction between the cheek and the lower eyelid, making the entire area flow together as it did in youth.

Fat or Fillers - Aging Eyes

“When we do lower eyelids, we often use fat or fillers in the cheeks to make the cheeks come out,” adds Patel. “That really then makes the eyelid and cheek junction very confluent and natural looking.”

Non-Surgical Options

If you have bags under your eyes and you would like to know if a non-surgical procedure, such as fillers, could help camouflage the problem without surgery, the best person to see is a board certified plastic surgeon. Unlike someone who only offers fillers, a surgeon experienced with both will be able to examine your face and tell you what type of results you could expect with both options.

“There are methods that people try to use, such as fillers, to try to correct the signs of aging in the lower eyelid,” says Patel, “but that can often cause clumpiness when you don’t realize that the patient actually needs a surgical procedure.”

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