Dear Dr. Seckel, I am 38, fair skinned and thanks to my parent’s genes still look much younger than my age. My eyelids are starting to change and look older than the rest of my face. The upper eyelids are starting to droop and form hoods over my eyes and I am starting to have dark circles and bags under my eyes. I am using the Obagi products and have tried the Teamine complex but I really don’t see any improvement. I don’t want blepharoplasty or plastic surgery. I have read about a non-surgical blepharoplasty online. Does it work and how is it done, Thank you, Katie, Boston, MA.
Dear Katie,
The eyelids are the first part of the face to show signs of facial aging in almost all people. In many people, especially people with fair skin the eyelids start to show aging changes as early as the late 20’s. The first signs of eyelid aging are laxity or loose skin of the upper eyelids which eventually causes eye hoods or hooding of the eyelids, a condition technically called dermatochalasis. In advanced stages hooding of the eyelids can be severe enough to interfere with vision.
The lower eyelids age differently because of the action of the orbicularis occuli muscle on the lower eyelids. When we smile or close our eyes, the orbicularis occuli muscle squeezes the eyelid and causes crow’s feet and eyelid wrinkles to appear. Eventually after years of this muscle action on the eyelids, the crow’s feet and eyelid wrinkles become permanent.
Bags and dark circles under the eyelids are a very common complaint and are not always a sign of eyelid aging. Many people complain of bags and dark circles under the eyelids in their 20’s. With eyelid aging the eyelids become lax, the eyelids sag and fall over the dark circles under the eyelids and the dark circle shadow becomes deeper and darker.
In my experience skin or eyelid creams are not very effective at correcting eylid aging. Blepharoplasty has been the traditional plastic surgical operation to correct eyelid aging. However as you point out there is much talk about a non-surgical blepharoplasty or non-surgical rejuvenation of the eyelids today.
In my opinion there is no specific procedure which I would call a non-surgical blepharoplasty that I know of. There are several procedures which can help achieve non-surgical rejuvenation of the eyelids, but I would not call any of them a non-surgical blepharoplasty.
The techniques that are being used for non-surgical rejuvenation of the eyelids today are most effective for wrinkles of the eyelids. There are techniques for tightening of the skin of the eyelids although correction of significant eyelid hoods non-surgically is not yet possible. The eyelid bags and loose skin can be improved but not totally corrected with eyelid skin tightening. Correction of dark circles under the eyelids still requires plastic surgery in my opinion, as filler injection to correct dark circles under the eyelids is, in my opinion, dangerous. The techniques that I have seen called the non-surgical blepharoplasty are:
- Botox to remove crow’s feet and improve eyelid wrinkles of the lower eyelids. Botox works very well, is safe, and is the first procedure I use for non-surgical rejuvenation of the eyelids.
- Laser skin rejuvenation of the eyelids is a very effective method for removal of eyelid wrinkles. I use the ActiveFX laser skin peel which is safer than traditional laser resurfacing, but less effective. There is down time, usually 4-7 days, but the laser skin peel is much more effective for eyelid wrinkles than any skin cream.
- Non-surgical skin tightening of the eyelids is possible with the new skin tightening machines such as the Aluma with FACES. Care must be taken to avoid injury to the eyes, but improvement in the appearance of the eyelid skin with tightening and improvement in eyelid wrinkles is possible, but 4-6 treatments are needed. Skin tightening is not a non-surgical blepharoplasty as advertised.
- Soft tissue filler injections to correct dark circles under the eyes is being done by many physicians and is being advertised as a non-surgical blepharoplasty. I do not do soft tissue filler injections into the eyelids and I do not recommend it. I believe there is risk of injury to the eye by the needle used for injection and there has been a reported case of blindness caused by soft tissue filler injection into the eyelids in
England . I have also seen and heard of terrible results following soft tissue filler injections into the eyelids.
Those are the non-surgical eyelid rejuvenation techniques I am aware of and have seen advertised as the non-surgical blepharoplasty.
The most important advice I can give you is to seek consultation with a board certified dermatologist or plastic surgeon that has a good reputation and get their advice. If someone tells you they can give you a non-surgical blepharoplasty I would ask them exactly what they mean and how they plan to carry out the non-surgical blepharoplasty.
Although there are helpful non-surgical eyelid rejuvenation techniques available the use of the term non-surgical blepharoplasty at this time is a marketing euphemism. For more information on non-surgical eyelid and facial rejuvenation read Save Your Face or contact me.
Thank you,