Aging is inevitable and it begins to appear first around the eyes. With familiar names, such as crow’s feet, 11s, dark circles, bags and hooding, they indicate how visible and concerning these aging issues around the eyes can be. While surgical eyelid tucks and browlifts can offer dramatic improvements, many women and some men would prefer to try and prevent or even camouflage these eye flaws before considering surgery.
There is a progression of non-surgical treatments for keeping the eye area fresh and less old and tired looking. Known as periorbital (around the eye) rejuvenation, these include a variety of treatments combining neurotoxins, fillers, laser devices and topical products. These types of treatments usually follows the age of the person. Those in their 30s and 40s usually just need Botox to control the frowning and squinting. Fillers and light and laser treatments are added for those in the 40s and 50s. At 50 and beyond, only surgery can remove loose upper eyelid skin and lower eyelid bags. But these non-surgical treatments are still very useful to protect and maintain one’s surgical results.
Botox is the most recognizeable name when it comes to injectable wrinkle reduction since it was the first to be used. But it is no longer alone as two other injection drugs, Dysport and Xeomin, are now also available. While patients often believe that one of these is better than the other, they are all comparable in most cases. The differences between them is perceptual and not factual. They all take a few days to start working and will last in the range of three to four months. One is not more powerful than the others nor does one cost less. Because these injections are given by the unit, the cost per unit varies for each one but so does their effectiveness. (e.g., 1 unit of Botox equals 3 units of Dysport) As such their treatment costs are all about the same.
While Botox is the backbone of non-surgical eye treatments, injectable fillers can also play a role. Many people will develop shadowing and tear troughs under the lower eyelid, sometimes as early as the late 30s and early 40s. This can be treated with fillers placed to fill out them out. While they are over a dozen types of injectable fillers, the hyaluronic acid-based fillers (e.g., Restylane and Juvederm) are preferred as they can be delivered smoothly into the thin skin of the lower eyelids with minimal risk of lumps and irregularities.
While eye lines and wrinkles can be held in check with Botox and fillers, they can not reverse skin color and texture problems. Broken blood vessels and brown spots can be improved with high energy light therapies known as IPL or BBL. These are often confused with lasers which they are not. But when it comes to improving skin textureand reducing fine lines and wrinkles, laser resurfacing around the eyes can produce results that not even a formal eyelid lift can do.
Topical skin care products are important to help maintain the benefits of these injectable and energy treatments. The skin around the eyes is so thin that it responds well to many vitamin C, retinoid and antioxidant-containing products. A new topical product, Latisse, is great for thinning eyelashes and eyebrows and it works like nothing else. Having thicker eyelashes and eyebrows can really add to a more youthful look.
While surgery may be needed or inevitable for some, younger and less tired looking eyes may be just a few injections or the pass of a laser beam away.
Dr. Barry Eppley
Indianapolis, Indiana