Improving the appearance of the eyelids and skin around the eyes can be accomplished without surgery in many cases. At The Menkes Clinic, our doctors are skilled in enhancing the eyes and eyelids using a variety of non-surgical techniques, including Restylane®, Juvéderm® and Radiesse®. These injectable gels restore volume to hollow grooves and under eye circles to give a fuller, more youthful appearance.

Restylane®, Juvéderm® and Perlane® are hyaluronic acid gel fillers, which provide excellent wrinkle smoothing results. Created from non-animal, biocompatible (causes no harm to the body) as well as biodegradable (able to be broken down by the body) substances, these gel fillers are injected within the skin to restore volume and smooth out the contours of the skin's surface. Typical treatment areas include the nasal creases and smile lines, the under eye areas and the frown lines. After treatment, your skin will feel smooth, soft to the touch and look completely natural. Since Restylane®, Juvéderm® and Perlane® contain lidocaine (a commonly used anesthetic), no additional anesthesia is required. When Restylane®, Juvéderm® and Perlane® dissolve, they do so evenly and symmetrically, without bumps or irregularity.

Causes of Eyelid Aging

• Genetic Factors
• Your Anatomy
• Skin Changes
• Herniation of Orbital Fat
• Facial Volume Loss
• Lifestyle choices
• Allergies/Irritants

Genetic factors definitely play a significant role in the aging process, especially around the eyes. It is very common to have changes in the eye area similar to those of close relatives, especially parents, who may also have droopy eyelids and dark eye circles. Human variations in anatomy are also very important to consider. These are normal person-to-person differences caused by heredity and include the position of the upper and lower eyelids, the angle of the corner of the eyes, the position of the cheekbones and forehead. All of these genetic traits can affect how the face changes with aging, and taken together will determine the most effective treatments for each individual. For example, a patient who has deeply set eyes will often require a different treatment plan than an individual with very prominent eyes. The aging process is unique to each patient and varies significantly depending on the anatomical differences between individuals.

Skin changes related to aging also profoundly affect the eyelids. As the skin normally ages, loss of subcutaneous fat is common. Another normal consequence of aging is the decrease in skin elasticity, or the ability of skin to "snap back" to its original position after gentle pulling. When this occurs in the thin skin of the eyelids, it results in skin stretching and gives the appearance of excess skin on both the upper and lower eyelids. Frequent eye rubbing can also accelerate these unwanted changes.

There is a structure in the eyelids called the "septum" that helps prevent the fat surrounding the eyes from moving forward to protrude outside of the eye socket. Part of the reason we get lower eyelid bags is because over time, the septum weakens and allows the fat that should normally be in the eye socket to move forward and into the lower eyelids. This is referred to as "herniation of orbital fat" and results in the appearance of lower eyelid bags.

Loss of facial volume, which includes a decrease (resorption) in the thickness of the facial bones, muscles and fat, is a result of the normal aging process of the face over time. The result is a descent of the midface and cheeks that are worsened by the effects of gravity. Facial volume loss contributes to the formation of bags under the eyes, facial jowls and lines around the nose and mouth. As the tissues of the face droop, lower eyelid bags become even more prominent.

Lifestyle choices can also affect how the skin ages. Lack of sleep, sun exposure, and poor diet can accelerate the aging process of the skin, particularly of the face. Optimizing sleep to at least 7 hours each night, using effective sunscreen (with both UV-A and UV-B coverage), wearing UV protective eyewear and eating a balanced diet rich in green vegetables can effectively slow down the aging process around the eyes. Patients should also avoid allergens and irritants that may cause excessive swelling, itching and rubbing of the eyelids. These factors can lead to worsening of the lower lid bags and dark circles around both upper and lower lids.

• Non-surgical treatment
• Quick, 30-minute procedure
• No additional anesthetic required
• Effective and natural looking results
• Minimal discomfort and little downtime
• Restylane®, and Juvéderm® results lasts up to 8 months
• Perlane® and Juvéderm® Ultra Plus lasts up to 12 months

After your treatment there may be mild, temporary swelling and tenderness that resolves completely within a few days. Ice compresses are applied immediately following injections to help reduce the amount of swelling.

Restylane®, Juvéderm® and Perlane® are FDA approved and created from non-animal, biocompatible and biodegradable to restore volume and smooth contours in the skin. Most common side effects are related to temporary injection site reactions. You may experience some redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching or bruising. These are temporary reactions and are short lived (generally less than 7 days). Hyaluronic acid fillers are biocompatible so skin testing isn't required prior to treatment.