21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

Eyes are one of the first areas to show the earliest signs of aging.

There has been a lot written recently about the pandemic induced uptick in aesthetic procedures to address the eyes. Some articles say that it is the result of all of us staring at ourselves on Zoom for the past year. Others claim that it is because masks place more emphasis on the eyes. While both of these are true, rejuvenating the eyes without surgery has always been a huge part of my practice. This is because your eyes are not only one of your more identifiable features, but it’s how you convey emotion. Shakespeare had it right when he wrote that “the eyes are the window to the soul”.  Unfortunately, they are also one of the first areas to show the earliest signs of aging. This is why I am excited to talk about my 3 best non-surgical procedures for rejuvenating the eyes.

What Causes Aging Around the Eyes?

As a Board-Certified dermatologist, my job is to assess the skin and tissues of your face and body, and come up with the most effective and least invasive way to improve how they look so you feel more confident, vital and youthful. This always begins with an in-person consultation and patient education. One of the main reasons that your eyes tend to age faster than the rest of your face is that the skin around them is actually 10 times thinner. So, lifestyle choices such as:

  • Smoking
  • Sun exposure
  • Living in or near a polluted city
  • Skincare routine
  • Hydration

These can all have a bigger impact on the delicate eye tissues than, for example, the skin on your cheeks. Furthermore, rubbing your eyes because of allergies or because you’re tired can cause further stress. The end result is fine lines and wrinkles.

Genetics also play their part. If you have a very expressive face, you are going to develop crow’s feet sooner than someone who doesn’t. And if your mother has dark circles under her eyes, chances are you will as well. Luckily, there are a lot of good options for addressing these issues without having to go under the knife.

CO2 Laser for Rejuvenating the Eyes

Lasers are one of my specialties. I love their ability to address all your skin’s aging issues. My favorite aesthetic procedure, out of a very full repertoire, is the CO2 laser for rejuvenating the eyes. It pretty much allows me to perform a non-surgical upper and/or lower blepharoplasty. In the right patient, it can improve the appearance of:

  • Crepey skin texture on the upper and/or lower eyelids
  • Crow’s feet
  • Mild to moderate sagging skin in upper and/or lower eyelids

Ideal for both men and women, this is a more aggressive ablative laser that does require some downtime. I also typically recommend 3-4 treatments spaced out over a year. However, the results are seriously rejuvenating without the need for incisions and can last anywhere from 3-4 years depending on your lifestyle.

Under Eye Filler

Looking tired may be the most common complaint that I hear from my patients. While sometimes this is due to a lack of sleep, more often, it is the result of dark circles under the eyes. As discussed, these can be genetic, but dark circles can also be the result of:

  • Volume loss under the eyes
  • Allergies
  • Age
  • Puffiness
  • Blood vessels
  • Discoloration

While I will often use a combination of procedures to rejuvenate the eyes, a filler procedure is definitely my go-to for addressing dark circles due to volume loss.

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With each passing birthday, your body sadly produces less collagen and elastin. These are what make your skin look lifted and plump. Less of both in the delicate eye area means that blood vessels become more visible, and your eyelid/cheek juncture actually elongates. This, in turn, can make the area under your eyes look, ironically, more puffy and hollow at once. Properly placed filler, however, can alleviate these issues by giving you back some of your youthful plumpness. I typically use Restylane® under the eyes as it is a lighter weight, hyaluronic acid (HA) based filler. Since HA is a naturally occurring substance in your body, I find it best for sensitive areas such as the eyes. I also use a cannula instead of a needle as I’ve found it to be safer, and it also lowers the risk of bruising.

Botox® for Crow’s Feet

Last, but certainly not least, is a neurotoxin such as Botox® for reducing the appearance of crow’s feet. These are the fine lines that develop on the outer corners of your eyes when you smile. For many of my patients, Botox® for reducing the appearance of crow’s feet is their gateway procedure into eye rejuvenation as this is an issue that can develop as early as your 20’s. I am also a proponent of pre-juvenation. Since neurotoxins work by relaxing the dynamic muscles around your eyes, treating your crow’s feet with a little Botox® before these fine lines begin to appear may actually stave off their formation for longer. As I said, my goal is to help you look and feel your best with as little downtime as possible. These 3 non-surgical procedures for your eyes are my go-to’s because they consistently deliver results for my patients.

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To find out more about CO2 laser, filler and Botox for rejuvenating the eyes at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.


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