The Lower Eyelid Dilemma

By Soheila Rostami, MD

One of the most difficult surgical areas to treat is the eye area. There can be many issues to address in this area in people of all ages. Dark circles, puffiness, skin laxity, fatty pads in the lower lids, hollowness, and/or loss of volume. Any or all of these factors can make a person dissatisfied with the way their entire face looks.

An oculoplastic specialist can improve these issues with a combination of treatments. Not everyone requires all the procedures mentioned below to achieve improvement in the appearance of their lower eyelids.

In younger patients desiring improvement, a filler such as Restylane would be appropriate. If there is some atrophy (decrease/depression) of the cheekbone or mid-face deficiency, Restylane with a Radiesse injection in the cheek area will give lift to the cheek and boost the lower eyelids, giving the area a much younger-looking appearance.

With patients in their 40s and 50s, adding Botox or Dysport to decrease “crows feet” (the corners of the eyes) can help improve appearance. Also, Fraxel treatments of the lower eyelid skin or TCA chemical peels will tighten the skin. If there is a herniation of the lower eyelid fat, having the fatty pockets conservatively removed via invasive outpatient surgery could be recommended. Fillers in the lower eyelids of these patients, as well as in their tear trough area, will increase optimum results.

In elderly patients, having subciliary lower eyelid blepharoplasty with or without any fat removal (depending on any signs of fat herniation) is recommended. These patients will benefit from Radiesse injections in the cheek area, since bone volume is lost from our faces as aging occurs.

An oculoplastic specialist is very familiar with the anatomy and blood flow of these areas. The eyelids and surrounding areas are very unforgiving, and any mistake in this area can be very difficult or even impossible to repair. When considering the use of fillers, injections or surgery of the areas around your eyes, it is always best to choose a surgeon who is properly trained and experienced with these types of very delicate procedures.

The improvement of the eyes and areas around the eyes is beneficial for people in almost any age category. Younger patients can improve a countless number of cosmetic issues while older patients can improve both cosmetic and medical issues that can dramatically improve their life. Do you think that now is the time for you to consider rejuvenating the appearance of your eyes through the use of fillers and/or a surgical procedure? Consult a board certified oculoplastic surgeon today to see which treatment is best for you.