The Lower Eyelids
Beautiful Eyes Part 2: Lower Eyelids
What makes beautiful eyes so attractive? We know that a combination of factors in both upper and lower eyelids give us the impression of a person’s age, mood and energy. So what can be done to keep the eyes looking fresh and youthful? With all the lotions, potions, facial treatments and injectables that you have to choose from, it can be difficult to figure out what really works.
Last week we talked about the upper lids. Today we will focus on the lower eyelids.
Puffy Eyes and Bags
First you have to figure out what is causing them and see if you can help by first changing something in your routine. Common causes for these bags are swelling from too much or too little sleep, crying, allergies, smoking, and too much alcohol. Sometimes just using gravity to help by sleeping with your head up on a few pillows can bring down the puffiness. Watching your salt intake by keeping away salty foods can also help. And just like all your skin, it is really important to keep the skin under your eyes hydrated with a good moisturizer. Although eye tighteners and serums can be used to give some temporary firmness to the skin they rarely result in any long term benefit.
Age and genetics are also factors. The bags can be due to small fat pads that have collected there and become more visible with time. Loss of skin elasticity due to age can also leave you with excess skin that may need surgical removal
Here are some common complaints and how to specifically address them:
Tear Troughs or hollowness under the eyes
We normally lose fat in specific parts of our face as we age and one of the most noticeable areas is the ridge between the lower eyelid and the nose. This results in a hollowing under the eyes that is often called a tear trough and can be improved with a filler such as Restylane or Juvederm. You can also reverse this by transferring some of your own fat back into the area.
A filler can be done in the office of a plastic surgeon in about 30 minutes. Basically, the product is injected with a small needle to fill up the hollow area. It is usually mixed with numbing medicine so no other anesthesia is needed and you can go back to work the same day. Some people may experience mild bruising that can be covered up with make-up. The fillers placed under the eyes can last up to a year which is longer than when placed in other parts of the face.
Fat transfer or “fat grafting” can also be done in the office by a plastic surgeon using oral sedation like Valium and local anesthetic to numb the areas. A few syringes of fat is often taken from the abdomen (although really any area with excess fat can be used) and transferred into the tear trough. The procedure takes about an hour. Most of the transferred fat survives and the results can last several years giving you a fresh and natural appearance. Like the other fillers, there may be some swelling and bruising, but this usually resolves in a few days.
What about Lasers?
There are a ton of different lasers and brand names on the market each claiming to be the best one. Each type of laser does a different things like hair removal, zapping spider vessels, and clearing tattoos. The resurfacing lasers are what are essential for the lower eyes. Basically a microscopic layer is removed from the top of the skin stimulating collagen production which leads to a tighter smoother skin surface. The deeper the laser penetrates, the more effective the results. Don’t be distracted by all the different brand names used for marketing since many are really same kind of laser just by different company. Usually a doctor is required to administer more agressive treatments with the more powerful lasers.
Laser treatments are usually done in the office using numbing cream. There will be redness and swelling for a few days after. The deeper lasers have a longer downtime…you may peel and look like you have a really bad sunburn for about a week, but then you will look awesome!
Lower Blepharoplasty (Lower Eye Lift)
A lower eyelid lift or blepharoplasty is a surgical procedure where a small amount of fat is removed and the rest is rearranged so it can blend in over the tear trough area to create a smooth transition between the lower eyelid and cheek. This is usually done under anesthesia through a small incision that can be hidden inside the eyelid or in the lash line that is essentially invisible. Most people are able to go back to work after a week.
Remember, anytime you have any procedure done around the eyes, it is important to use cold compresses and sleep with your head up for a week. Also, avoid any blood thinning products like aspirin, ibuprofen and fish oil for 2 weeks before having a procedure to reduce the amount of possible bleeding and bruising that can lead to complications.
If you decide that you want to have a cosmetic procedure, again please make sure that you choose a board certified plastic surgeon that has a lot of experience in this area and can safely help you plan the best procedure for you.