Dr. Leonard Miller giving patient Botox and filler at Boston Center for Plastic Surgery.

02 Jan 2024 | by Dr. Leonard Miller, MD

Aging around the eyes is one of the top reasons why a patient first comes in to speak with me. As a long-time expert in facial rejuvenation, I am also somewhat of a pioneer in the field of non-surgical rejuvenation. Historically, my only avenue of recourse for patients who were unhappy with the appearance of their eyes was upper or lower blepharoplasty. We are always listening to our patients, however, and one of the primary things that they want is to achieve a more youthful, vital, and energized look without the need for incisions, anesthesia, or significant downtime. With today’s advancements, it is now entirely possible to significantly improve the appearance of your eyes without surgery. 

Botox® for Wrinkles Around the Eyes 

Understanding why the skin and tissues around the eyes age faster is important. To begin, the skin around your eyes is thinner and more delicate than that on the rest of the face so it is more susceptible to wear and tear. The muscles around your eyes are also highly active. They contract whenever you blink, squint or sneeze, for example. The area around the eyes is also more sensitive to irritation and trauma. This helps explain why you may feel like you look “older” or more “tired” during allergy season or after a cold. 
Other factors that may speed up aging around the eyes include: 

  • Genetics
  • Lifestyle choices such as sun exposure
  • Expressiveness of face
  • Diet, particularly hydration
  • Skin care 

Aging around the eyes typically first manifests as fine lines and wrinkles. The onset can be as early as 25, depending on the above factors, but most all of us notice some crinkling by our early 40’s. Botox® is often the first line of defense. By precisely injecting a neurotransmitter into the muscles beneath your crow’s feet, I can quickly and easily diminish lines, brighten the entire look of the eye, and make you look and feel more energized. It’s one of those procedures with a significant pay off. 

Fillers for Under Eye Hollows 

Another very common issue for non-surgical eye rejuvenation patients is a hollowing around the eyes, particularly in the tear trough area. As we age, we lose fat or volume in our skin and tissues everywhere. It is one of the biggest components of facial aging. Replacing this lost volume with an appropriate filler or micro-fat injection is one of my go-to procedures for refreshing your eyes without surgery. However, it is critical that you see a really experienced plastic surgeon, such as myself, or cosmetic dermatologist as you do not want to adversely affect the appearance of your eyes. Even a small amount of misplaced or excess volume may throw off their entire shape. 

How to Ensure that Your Eyes Stay the Same Shape 

Your eyes are more than just an important facial feature. They convey your feelings and thoughts, and thus are intimately tied to your personality. We have all seen famous people who have changed the shape of their eyes, and they no longer look like themselves. I have always prided myself on delivering a natural looking result. It is the bedrock of my practice philosophy. Seeing an injector with a lot of experience treating the eyes is non-negotiable if you want to ensure that your eyes stay the same shape. In my case, I have the additional benefit of being a Board Certified Facial Plastic Surgeon so I have a deep understanding of facial anatomy and how all of the muscles, tissues and bones interact. 
One of the reasons that non-surgical eye rejuvenation is an area of expertise for me is that it’s not easy to achieve significant results without surgery. This makes the procedure both technically and artistically challenging, which is a combination at which I’ve always excelled. 

Exemplary Results = Conservative, Layered Approach 

I achieve great results by first taking a conservative, careful approach. Any kind of aggressive procedure in the eye area can be risky. This typically means that you are going to need repetitive treatments as well as a combination of non-surgical modalities to address the aging around your eyes. In addition to Botox® and fillers, other procedures that I may recommend include: 

  • Fractional ablative laser
  • Micro-fat injections
  • Microneedling with or without radiofrequency (RF) 

Since every patient is unique, my job is to devise the right treatment plan for your anatomy, goals and lifestyle. For example, a fractional ablative laser treatment can deliver some skin tightening, but it can also take weeks to months, depending on the severity of your issues, for the post-procedure redness to completely dissipate. You may have a job where you need to get back on Zoom in a couple of days so this might not be for you. These are the things that we will discuss in detail during your initial consultation. 

Ideal Patient for a Non-Surgical Eye Lift 

The ideal patient for a non-surgical eye lift is any man or woman in good overall health, who does not smoke, and who is bothered by: 

  • Fine lines & wrinkles
  • Hollowing under the eyes
  • Chronic dark circles 

If you have a moderate to severe amount of excess skin in the upper and/or lower lid, you may be a better candidate for a surgical procedure. Again, I will be able to give you a truthful assessment of what you can and cannot expect to achieve non-surgically once I see you in person. 

To find out more about a non-surgical eye lift, or any other surgical or non-surgical procedure with Dr. Leonard Miller at the Boston Center for Plastic Surgery, contact us today or call (617) 402-2768 to schedule a consultation at his Boston or Brookline offices.


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