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Dr. James Chelnis is a cosmetic facial surgeon whose unique expertise in rejuvenation and maintaining a youthful appearance starts with your most alluring physical attribute, your eyes. Dr. Chelnis understands our eyes to be the focal point of our communication with others and has dedicated his career to rejuvenating his patients’ faces starting from this principal building block. 

Eyelid skin is the thinnest skin we have, being as thin as one-tenth of a millimeter (!) and is unique in its structural make up relative to skin everywhere else on the body! In addition, lymphatic channels from the immune system drain under this thin lower lid skin. Think of all the toxins that enter your body and that are faithfully removed from circulation over your lifetime. Slowly, small amounts accumulate and, unlike, a Brita water pitcher, we can’t remove the old filter and put in a new one! This along with other important factors, such as sun exposure and contours promoting shadowing, makes the area under the eyes pigmented and dark. 

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 So what can you do about this?

Well there are a number of things, and as always, the treatments must be individualized for the person. Some treatments such as resurfacing can tackle a number of the characteristics that most patients want to improve, including improvements to the skin texture and laxity as well as the density and irregularity of pigment. Resurfacing can be done with a variety of lasers and chemicals that force the treatment area to abandon the older top layers of skin and promote the development of a new more youthful layer of skin. 

 Some of the effects of under eye darkness can be improved with filler or surgery as well. Surgery is the more obvious option because it’s easier to understand how recontouring an area and removing the excess wrinkled skin can improve the appearance under one’s eyes. But new filler technologies also allow improvement in contouring and the refraction of light to alter the darkness of the settled pigment. The nuance needed to deliver the correct filler to the correct layer within the anatomy of the eyelid makes having an expert vital. There are offerings from each of the “big 3” in the United States: Allergan, Galderma and Merz. 

 Recovery from each of these options: resurfacing, fillers, and surgical correction is variable, but generally, fillers are the least involved and are commonly associated with no or very limited downtime. Peels and laser resurfacing can also often be done in the office but commonly have a several day recovery period. Sometimes, a combination produces the best results, only an expert can distinguish patients by their treatment needs. Overall, the bottom line is that, for patients who are tired of looking tired, there are several treatments available!