Last month, Beverly Hills oculoplastic surgeon Dr. Christopher Zoumalan discussed the various causes of under-eye bags and puffiness—along with the best rejuvenation treatments. Here, he speaks about how the aging process affects the upper eyelids and the role the eyebrows play in one’s overall appearance as well.
The eye area is usually the first part of the face that exhibits visual signs of aging, and this can be due to the passing of time, genetics and external factors that compromise the skin as well as underlying supportive tissues. The skin and muscles around the eyes naturally loosen with age, which can affect the position of fat and lead to sagging of the upper eyelids. Fat loss can also lead to a hollow appearance in the upper eyelid area, while other patients may experience unwanted lid fullness due to fat accumulation. The brow area also experiences age-related changes that include drooping due to lax muscles and etched-in lines caused by years of repeated facial expressions. However, there are non-invasive and surgical rejuvenation solutions for all of these concerns.
Botox
Injections of this muscle-relaxing neurotoxin are extremely effective for improving visible lines and wrinkles around the eyes, between the brows and across the forehead. But in the properly trained hands, Botox can also give the brows a subtle lift. Ideal for those seeing the first signs of aging in the form of slight sagging of the upper eyelids, targeting specific forehead muscles with these injections can help decrease the downward pull and restore the brows to a higher position.
Blepharoplasty
The gold standard for rejuvenating the eye area, this surgical procedure utilizes a variety of techniques to eliminate excess skin, reposition fat and restore a more youthful appearance. Treating the upper eyelids requires an incision within the natural crease of the lid, which is virtually undetectable once healed. Additional post-surgical treatment with an advanced scar cream such as Skinuva, which is formulated with selective growth factors, can further help accelerate the healing process and minimize scars. Most patients are surprised to learn that blepharoplasty can be performed under local anesthesia if no other additional techniques or procedures are involved, and that recovery is rather quick and painless.
Browlift surgery
When the brows need more than the subtle lift that can be achieved with Botox, a browlift may be recommended in addition to blepharoplasty for excess eyelid skin. There are a variety of browlift techniques and the best approach is dictated by the patient’s unique needs and goals. In some cases, a browlift can be performed through the upper blepharoplasty incision, while patients who need more extensive correction may require incisions within the hairline. In many cases, combining these surgical procedures reduces the amount of skin that needs to be removed from the eyelids—and yields more comprehensive yet natural-looking results.
When considering eyelid or brow surgery, it’s important to select an extensively trained surgeon who specializes in these areas and takes the overall appearance of the face into consideration. In patients with more advanced signs of aging, blepharoplasty (with or without a browlift) alone is unlikely to meet a patient’s rejuvenation goals, and additional procedures such as a facelift or necklift may be recommended to achieve the optimal anti-aging outcomes.
For more information, visit Christopher Zoumalan, MD FACS's social media:
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