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The eyes are always the first area of the face that begins to show the effects of age. They are also the most easily perceived as they are continuously viewed in conversational interactions. But of the many aging eye features that will develop, which is best treated by surgery and which are better treated by the numerous non-surgical treatments methods now available. For crow’s feet wrinkles consider Botox injections and fractional laser resurfacing. For dark circles and under eye hollowing (tear troughs), the addition of volume through hyaluronic-based fillers can be very helpful. For small amounts of undereye wrinkles and loose creepy skin, chemical peels (TCA) or light fractional laser treatments can tighten up some loose skin. But for a lot loose skin and wrinkles and large undereye bags, a surgical blepharoplasty is far more effective. Not surprisingly, age plays a major role in the line between non-surgical vs surgical eyelid rejuvenation. Injectable fillers and skin resurfacing have a much bigger role in those patients under 50 years of age. In addition, unlike the lower eyelid, the upper eyelid can only largely be treated by surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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