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I Spy Younger Eyes

By Peter Schmid, DO
Posted On Dec 06, 2010

WORDS: Lisette Hilton
Noninvasive options uncover younger, tighter, smoother skin in the delicate eye areas
hey say that the eyes have it, and it’s especially true when it comes to aging: They are the first place on the face that you notice lines, a loss of volume, pigment changes and sagging skin. But you don’t have to settle for eyes that look older than your years; thanks to modern marvels in the cosmetic surgeon or dermatologist’s office, you can send those bags and wrinkles packing while you look like you’ve just returned well-rested from a rejuvenating vacation.


“Skin is the thinnest around the eye area. Because of that and stretching from movement, it eventually loses elasticity. That’s when you’ll start to see creases, fine lines and crow’s feet,” says Soheila Rostami, MD, an oculofacial cosmetic surgeon in Reston, Va.

First, the skin around your eyes is always moving—everything from blinking and squinting in the sun to tugging when you apply eye makeup—and those small actions can lead to deeper, more prominent lines. Second, when you’re tired or if you suffer from allergies, dark under-eye circles appear. They age you as well, emphasizing a hollowed-out look by the corner of your eye near your nose (known medically as tear trough depression) and a sagging face.

“If your cheekbone structure isn’t strong, it starts to sag, and a depression forms around your lower eyelids. If you have this, it’s not necessarily a change of color, but shadowing from the indentation around the bone. As a result, your eyes appear dark and saggy,” says Dr. Rostami.

That was certainly the case for Mae, who at 42 felt she always looked tired and drained. “The last few years, I definitely started noticing a sunken look around my eyes. My mom would say, ‘you don’t just have bags, you have luggage.’ I decided to make an appointment to see what I could do to look fresher and younger.”

Looking Forward

At a consult for wrinkles around the eyes, your doctor will assess your facial structure and entire eye area, and then present your options.

“I like to treat the younger patients without surgical intervention. Later on, if the eyelids droop, or there is severe bunching near the lower eyelid, I’ll talk to the patient about surgery,” confides Dr. Rostami.

For crow’s feet, the weapon of choice is a shot of Botox or Dysport. These neuromuscular inhibitors soften muscle movement and decrease wrinkling along the lower eyelid. For those stubborn fine lines beneath your eyes, your doctor may recommend light therapy or a chemical peel to smooth them away.

“Either one can give you nice skin tightening and lightening of dark circle pigment. How aggressive you go… depends on your skin tone, the severity of wrinkling and how much downtime you can handle,” says Joe Niamtu, DMD, a cosmetic facial surgeon in Richmond, Va.

If you have a hollowed tear trough, most doctors suggest a hyaluronic acid filler injection, such as Restylane, to bring back the volume. “It’s really the best for improving the empty look and fold formation,” says Dr. Rostami. “Plus, patients see immediate results— more volume, less shadowing—that last anywhere from six to nine months.”

After Mae weighed her options, she felt a filler injection was the way to go. “I wasn’t ready for invasive surgery yet; Restylane is much like a baby step and less scary to me.”

Procedure 411

If you opt for filler injections, you’ll be in and out in an hour, with virtually no downtime. “I didn’t feel any pain,” says Mae. “And I walked out of there with a slight redness that went away after I applied an icepack.”

You will need an aggressive TCA chemical peel or CO2 laser treatment to tackle the heavier stuff, however. If you opt for one of these you can expect to have redness and peeling for a least a week or two while your skin heals and builds new collagen.

With either of these there is a payoff—you won’t have to come back over the course of months (like with a less invasive laser treatment or light peels) because the effects last up to five years.

Seeing Results

Most patients notice a big difference immediately after their first session, especially with a neurotoxin or filler injection. “I looked in the mirror and saw that underneath my eyes it looked firmer and less hollow. It was a huge improvement,” says Mae.

Fillers will last anywhere from six to nine months while neurotoxin injections may last three to four. With light peels or non-ablative laser therapy sessions, (the less aggressive laser treatment) you’ll see fewer lines and smoother skin after a few treatments— and you’ll only have to come back for maintenance once a year.

Overall, patients like Mae are happy with their fresher look. “I look a lot less tired and not as drained. Eventually, I’ll probably do surgery, but I would definitely do more Restylane before I make that decision.”