Aging in eye area can create a “tired” look and is due to many factors: volume loss, sagging of the fat pads, eye bags, malar mounds, excessive/creepy skin. It becomes obvious that each patient’s treatment is highly individualized and very often, multiple modalities are required. Differences from side to side are very common as well.
The quickest and easiest treatment around the eyes is using neurotoxin. By relaxing the orbicularis oculi muscle, improvement in wrinkles known as crows feet is achieved. Elevation of the brows is created by relaxing the same muscle closer to the tail of the brow. Medial brow elevation is achieved by injections in the corrugator and depressor supracilii muscle. If there is a muscle roll under the under when smiling, this can be relaxed as well. Creating the appearance of a bigger eye is possible by injections in the lower eyelid, but only if there is enough ligamentous support (tested with the violin or bow string test).
There are many fat pads surrounding the eyes and brows that either lose volume or sag due to gravity. Volumizing the medial and lateral cheek defects will often give significant improvement to the eye area without injecting in the tear trough and are always treated first. If there is still a deficit in the tear trough, conservative volumes of filler can be injected deeply in the tear trough. It is always better to under correct this area and schedule a follow-up visit in 3 weeks. When a patient has prominent eyebags, filler can sometimes be used to camouflage the bulging fat. However, if the patient already has a full cheek, placing filler in the tear trough area can worsen the appearance. These are patients who require lower blepharoplasty. Brow lifting is possible with filler placed in along the superior orbital rim, supraorbital area, and in the temples. All filler placed in the periocular area is done with large cannulas to minimize bruising and downtime and the maximize safety.
When there is loose and creepy skin in the lower eyelid, laser resurfacing can improve this condition. Ablative lasers such as erbium or CO2 will give better results than non-ablative lasers but have more downtime and risks. Pigmentation will also improve with these lasers. Vascular lasers are needed for superficial veins and redness.
RFM is a useful treatment for malar mounds or bags. This condition is cause by a problem with lymphatic drainage and RFM seems to reduce the congestion. It is always more than one treatment. RFM can also improve wrinkles and creepy skin in eyelids.
Any patient with concerns around the eyes must have a skincare consultation with one of our aestheticians. Growth factors, pigment correctors, hydrators, vessel constrictors all have a roll in improving skin around the eye.
While surgery is not performed at The Aesthetic Clinique, it is often recommended to our patients. There are limitations to the nonsurgical approach to treat conditions such as eyebags, heavy eyelids, and drooping brows.