Created on 15th May 2009
Puffy bags, dark hollows and a saggy brow... sound familiar? Help is at hand with cosmetic procedures that aim to restore your eyes' youthful appearance with results that last. Jenny Pitt reports
In your 20s...
If you are aware of imperfections around your eye area, like bumps and dents in your eyebrows, for example, then a temporary cosmetic filler treatment may help to correct them. It's a quick, non-invasive treatment and you might want repeat filler sessions at a later stage, but for now you can achieve the results you want and feel more confident about your appearance.
A temporary filler is a clear gel, which is injected into the skin in tiny amounts with a fine needle. It gives instant results, creating volume, plus the benefit is that it can be corrected easily - the filler can be dissolved with another injection of hyaluronidase.
The injections may be slightly uncomfortable, but are not painful, and the filler can be massaged to achieve the best results. Most temporary filler treatments last for six to 12 months, after which repeat treatments can take place. As for more invasive procedures, most surgeons rarely perform them on patients in their 20s and will often discourage young people from having cosmetic surgery.
"I think surgery in your 20s is too early unless there is a long-standing problem, such as fatty bags under the eyes. Most of my patients are in their mid to late-30s," explains Raman Malhotra, consultant ophthalmic and oculoplastic surgeon at the McIndoe Surgical Centre, based at East Grinstead's Queen Victoria Hospital.
In your 30s...
Even though you're working hard and enjoying yourself, you might look much more tired than you actually are. Dark, hollow eyes are known in the business as the ‘tired-all-the-time-look' and may be ageing you prematurely.
The answer is tear trough rejuvenation which is designed to remove dark shadows with the use of a filler. It's injected into the bony orbital rim to give you a fresh, plumped-up look that cosmetics alone won't achieve. The results are immediate and the only side effects you may experience are bruising and swelling, which should disappear after a week or so.
It goes without saying that in-depth consultation with your surgeon is key to achieving the look you want. "I encourage patients to bring in old photos of themselves so we can work to recreate that look," suggests Raman Malhotra. And the effects of tear trough rejuvenation are long-lasting: "Fillers like Restylane or Perlane are put directly on to the bone and will last for a couple of years," he explains.
You may also start to notice the early onset of wrinkles for which Botox injections are effective. It has a two-fold use: it can reduce crow's feet and if it's injected in to the lateral brow, the Botox relaxes the muscle and droopy skin is lifted - this is known as a chemical brow lift.
But there can be disadvantages to using it, such as temporary paralysis and a ‘frozen' look. "If Botox is given badly it may cause temporary functional problems. Regular misplacement of Botox and paralysis on a long-term basis of the forehead muscles may result in an enlarged forehead with a downward drift of the brow, as well as a backward drift of the hairline. This can cause an elongated forehead appearance and also result in a hooded appearance of the eyelids," explains Naresh Joshi, consultant ophthalmic and oculoplastic surgeon at London's Cromwell Hospital.
In your 40s...
Saggy, baggy eyes can add on 20 years and you will be amazed at the difference an eyelid procedure will make. Eyelid surgery (blepharoplasty) tackles excess skin and fat, the aim being to eliminate hooding and saggy skin as Naresh Joshi explains: "Blepharoplasty of the upper eyelid most commonly corrects hooding. This may be due to skin, muscle and or fat. Blepharoplasty of the lower lid principally corrects the puffiness and sagging skin of the lower eyelid."
What's more, blepharoplasty can be effective without having to undergo general anaesthetic, while long-lasting results can be gained from relatively uncomplicated surgery.
"Upper lid blepharoplasty takes 45 minutes, while the lower lid takes 45 minutes for the minimally invasive transconjunctival approach to just under two hours for one that incorporates the mid face. All these procedures can be performed under local anaesthesia with sedation," says Naresh Joshi.
You may start to notice wrinkles are becoming more deep set and this is where fillers come into their own, especially in the brow area. In fact many surgeons are now opting to use fillers rather than a brow lift as patients request a full and youthful look, rather than a smooth one. "Lifting the brow can give a skeletal, just-had-surgery look. Techniques are now more about filling the brow with fat. It's not about looking tighter, but achieving more volume," says Raman Malhotra.
In your 50s and beyond...
Your skin has lost a lot of its elasticity and you may have discovered hollow areas in your face. You look older than you are - but you have the energy of someone half your age! You could opt for both upper and lower eyelid surgery (many people do) to remove excess bags and drooping skin.
"If both upper and lower eyelid surgery are required I would advise they are done in conjunction to reduce the downtime and bruising. However, I will sometimes dissuade people from having upper or lower lid surgery if this is minimal. Certainly the lower eyelid surgery is a much more involved procedure than the upper eyelid procedure," explains Naresh Joshi.
In fact, before you set your heart on a facelift, bear in mind that it might only be your eyes that need a surgical procedure, not your entire face. "Your eyes are so powerful in your appearance that if you had to choose between a facelift and an eye procedure, I would suggest the older you are, the better results would be gained if you opted for an eyelift. You could have a facelift, only to find the eyes are still wrinkly or hollow. An eye procedure will transform your face," suggests Patrick Mallucci, consultant plastic surgeon at London Plastic Surgery Associates.
The same goes for filler. If you want immediate, non-invasive results then consider the long-lasting benefits to be had, as Raman Malhotra explains: "A filler works well for patients over 50 who have experienced volume deflation. I find it's effective at improving temple hollows which can be ageing."
CS&AM
