Why the Eye Area Shows Signs of Aging First
It seems like the word “blepharoplasty” moved into everyday conversation almost overnight. Now, we can all pronounce it without tripping over a single syllable, and it’s easy to see why the medical term has resonated beyond ORs: When you look at someone’s face, so much of their character is in their eyes, after all, no one has written poems about, say, the chin, and to paraphrase Ralph Waldo Emerson, the eyes are the only feature that speaks every language. But at the same time, the eyes are the part of the face where we typically notice signs of aging first, and that can have a huge impact on the way someone looks. More often than not, patients concerned about eye area aging have upper blepharoplasty on their mind.
But the surgery is not a one-size-fits-all panacea for this incredibly complex area of the face; changes to the skin around the eyes as well as their underlying structure can mean that one person’s eyes age differently from the next. These differences can be nuanced, and there are targeted solutions, both surgical and nonsurgical, based on an individual’s needs. It all has to do with the main ways in which the eye ages: the skin becomes thinner and dryer, the brow drops a bit lower, fat pads reposition, and hollowness can set in.
Upper Blepharoplasty vs. Temporal Brow Lift: Choosing the Right Eyelid Surgery
If you put your finger right below your brow, that’s your brow bone skin, and a heaviness there is one of the first signs of aging around the eyes that we typically notice. It’s a huge part of why upper blepharoplasties have garnered so much interest as of late, but changes around the brows are much better addressed with a temporal brow lift than an upper blepharoplasty. When Dr. Diamond is evaluating signs of eye area aging, he might recommend a temporal brow lift to reposition the brows back to where they used to be instead of an upper blepharoplasty, in order to correct sagging or heaviness just below the brows. When the lid itself starts to look heavier, that’s when an upper blepharoplasty, which Dr. Diamond often performs in conjunction with a temporal brow lift, becomes appropriate, and can also address sagging and crepiness on the upper lids. During an upper blepharoplasty, Dr. Diamond removes excess skin while preserving the natural shape of the eyes, restoring the youthful, unique harmony of the face. The incisions in a temporal brow lift are made behind the hairline so scars are imperceptible, while the upper blepharoplasty’s incisions are hidden in the existing crease right above the upper lid, also making these incisions unnoticeable.
Nonsurgical Eye Aging Treatments: Neuromodulators, CO2 Laser Resurfacing, & Chemical Peels
Of course, surgery isn’t right for everyone in his clinic. Dr. Diamond has developed Diamond Eye Contouring to address myriad signs of aging around the eyes. It’s a comprehensive and customizable approach in which neuromodulators (Botox, for example), volume replacement with fillers, platelet-rich-plasma, chemical peels and lasers can strategically be used to subtly raise brows that have drooped, to soften crow’s feet, and as a halo effect, mitigate some of those little fine lines and puffs right under the eye that would otherwise become more obvious when we smile. (By halo effect, we mean that the neuromodulators are most definitely not placed right under the eye, but rather that when used correctly, the overall impact on the face can create more youthful-looking smile lines around the eyes when you laugh or emote.)
One of the biggest reasons we see signs of aging around the eyes earlier than the rest of the face is that the skin there is unique, it has naturally lower levels of a lot of the good stuff that’s in our skin as compared to the rest of the face, like firming collagen and elastin fibers, as well as hydrating ceramides, cholesterol, and fatty acids. It’s why the eye area is so susceptible to becoming dryer and crepey with age, to developing fine lines and wrinkles around the eyes, and to sagging. Gentle chemical peels and CO2 laser resurfacing can stimulate collagen production to thicken the skin under the eyes, so the area stays firmer, smoother, and brighter, and so it’s less susceptible to the shadows, lines, sagging, and crepiness that we otherwise see most readily under the eyes.
Lower Blepharoplasty for Undereye Bags: Treating Puffiness and Fat Pockets
As the anatomical structure of the lower eyelid weakens with age, the three fat pockets that sit below each eye can become more visible and might even protrude (or herniate), this can also occur with weight loss, as Dr. Diamond is seeing more frequently now with the use of GLP-1s. In addition, some people just genetically have this problem, they are born with it. Regardless of the cause, a lot of the time, undereye puffiness looks like a mountain, with a valley right under it. Smoothing that recessed area can have a huge impact in making puffiness less obvious, and Dr. Diamond has developed a unique technique for filling the area. This in office technique is based on his surgical technique of fat injections. During surgery, he injects microdroplets of a patient’s own fat (obtained from areas like the stomach or thighs) along the cheekbone in a vertical fashion to soften the junction where the undereyes meet the cheeks. This may also be combined with other surgery - a lower blepharoplasty for shrinking those fat pockets down and oftentimes repositioning the fat. During a lower blepharoplasty, an incision is made inside the lower eyelid, so there’s no visible scar.
The Right Approach to Eye Area Aging Is Personal
Every single face is different, and there’s no one surgical or non-surgical approach to eye area aging that’s right for everyone. It’s about assessing the face, the eyes, and the brows to determine the best approach for that part of the face that has inspired artists ever since we’ve had art, and so uniquely makes us who we are.
