Rejuvenating Your Eyes & Browlifts--Without Surgery
Posted: Thursday, September 14, 2006
by Nelson Lee Novick
Nelson Lee Novick, M.D.
Unquestionably, when it comes to judging someone’s looks, the eyes have it. Unlike in some Eastern cultures, we in the West tend to focus on the eyes when we relate to one another. Several of our pet expressions, like “seeing eye to eye" reflect this. Not surprisingly, then, any esthetic improvements made around your eyes can yield disproportionate benefits in your overall appearance.
Genetics, time, gravity, and sunexposure, unfortunately, all take their toll on this critical cosmetic area. Many of the changes we associate with aging are the result of shifts or loss in volume. In young people the heart-shaped fat pads of our cheeks sits directly over the cheek bones and serve not only to provide contour to our cheeks but to buoy up the delicate tissues under the eyes. As time passes, these fat pads gradually slide off its bony pedestals and descend downward and inward toward the nose, accentuating the smiles lines as they do so and creating a depressed channel below the eyes sometimes called a “tear trough." In addition, the thin skin immediately below the eyes is left elongated, deflated, crinkly, baggy, and pouched, like a balloon whose air has escaped after a long period of distension. To worsen matters, dark circles may become prominent as the tiny blood vessels below the surface once obscured by the fatty layer now show through the delicate skin below the eye socket.
Unwanted changes take place above the eye, as well. Loss and downward displacement of the fat directly below the brows, particularly at the outer corners, allows them to fall. With time, they take on a more horizontal male-type pattern, rather than maintaining the outward and upward flare characteristic of the youthful, female eyebrow. The result: tired-looking eyes and sagging eyelids.
Blepharoplasty, or aggressive eyelid surgery, which entails the removal of excess skin and fat, and browlifts to draw the skin upward, were at one time the only form of treatment available for these conditions. Unfortunately, these surgeries did not address one of the central problems: volume loss around the eyes. In fact, not uncommonly, by removing protruding fat pouches around the eyes, rather than repositioning them, and stretching skin taut, many patients were left appearing skeleton-like, with hollowed and sunken eyes.
More recently, we have come to appreciate that restoring volume around the eyes is a must for achieving a more youthful appearance. Since skin sags as we age, like a beach ball that has begun to deflate, the approach is no longer to blindly remove excess skin and outpouching fat, but to restore the original contour by blowing the ball back up, i.e. by putting back what is missing. And that’s was volume restoration can do, in minutes, non-invasively, i.e. without any need for cutting or the risks of intravenous sedation or general anesthesia.
Restylane, a synthetically produced hyaluronic acid derivative whose molecules have an enormous affinity for attracting water, is an excellent choice for dealing with these problems. Its use does not require pre-treatment allergy testing and its very smooth texture, in part due to the large amount of water it attracts and binds, imparts a natural appearance. Autologous fat transfer (i.e. fat taken from your own body and reinjected elsewhere) has also been used for this purpose. The downside of fat injections is that they necessitate a minor surgical procedure, akin to a mini-liposuction, in order to harvest the fat from the abdomen or thighs before processing and reinjection into the skin around the eyes. The obvious advantage of Restylane is that comes pre-packaged and may used right off the shelf without the need of any minor surgery.
Before treatment, the areas to be injected are numbed with local anesthesia. For what has been called a “liquid browlift," Restylane is injected directly under the lateral third of the brow to plump and re-elevate it. To rejuvenate the area under the eyes, it is instilled deeply along the outer half of the orbital rim (the bone below the eye socket) and then injected deeply above the cheekbone, in order to restore the youthful contours of those sites. By replacing volume to these areas, by “reflating" them, you can achieve diminution in crinkliness, obliteration of the tear troughs, and lightening of the dark circles. The entire procedure for both eyes usually takes no more than a few minutes.
Following treatment, you may experience some redness, mild swelling, and tenderness, which may last one to two days. Occasionally, you may develop slight bruising, particularly under the eyes, that can last several days. This is easily masked with appropriate coverup makeup. The effects of the treatment are immediate, and more than 90 percent of patients are extremely gratified with the results after just one session. Improvement generally lasts several months before a touch-up is needed.
More resistent or deeper lines and crinkles under the eyes may benefit from the addition of a few properly placed microdroplets of Botox Cosmetic. Botox, which has proven safe and highly effective in millions of people worldwide, works by weakening the muscular contractions of the delicate muscles below the eyes that contribute to these lines. Two tiny drops placed in the middle and outer thirds of the lower eyelid area are usually sufficient to diminish crinkles and crepeyness. Likewise, a “chemical browlift" using Botox can be achieved with a few droplets of the material injected under the lateral third of the brow and half an inch above the midline of the eyebrow on each side.
Happily, you no longer are forced to choose between aggressive surgery and living with tired, baggy, crepey eyes and droopy, saggy lids and eyebrows. A veriety of simple, non-surgical techniques now available can go a long way to rejuvenating your eyes and dramatically improving your appearance in just a matter of minutes.
Dr. Nelson Lee Novick is a Clinical Professor of Dermatology at Mount Sinai School of Medicine in New York City, an Attending Physician, and a former OPD Clinic Chief within the department of dermatology of the Medical Center. He also maintains a private practice in Cosmetic Dermatology and Cosmetic Dermasurgery on Manhattan's Upper East Side. His biography has been included in the most recent 46th through 61th editions of Who's Who in America, and he has been listed in Consumer Research Council of America’s Guide to America’s Top Physicians--2003-2006. He is also the author of nine trade books, over a hundred by-lined articles, and more than a half dozen audiotapes on skin care. He has written for many popular magazines and newspapers, such as Good Housekeeping and Reader’s Digest and has been quoted in all the major print venues, including the The New York Times, The Washington Post, and USA Today. He is a familiar face to network media and has been featured with Oprah Winfrey, Paula Zahn, Matt Lauer, and Joan Hamburg. http://www.skinsavvy.fromyourdoctor.com
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