Written By: Erin Storm, PA-C
Published: March 19, 2021
Last updated: August 31, 2021
For everyday skincare essentials, pre- and post-treatment support, procedure enhancers, or even treatment alternatives, we’ve got you covered.
The Skinny
When’s the last time a coworker, friend, or family member helpfully advised, you look tired? While we all appreciate a little loving concern, aging and tired eyes can be an unwelcome sight in the mirror especially after a refreshing eight hours. Under eye bags, crow’s feet, and a heavy brow are the main causes (check out our complete guide to Aging & Tired Eye Concerns). These concerns are common among men and women of all ages, and, fortunately, numerous surgical and non-surgical rejuvenation and corrective procedures exist.
The American Society of Plastic Surgeons (ASPS) reported blepharoplasty (a.k.a. eyelid surgery) was one of the top five cosmetic procedures of 2018 with over 200,000 operations performed. Blepharoplasty procedures, brow lifts, and injectables (like dermal fillers or Botox®) can be used by men and women to restore a youthful, toned, and refreshed appearing eye and brow.
The Specifics
Who may consider cosmetic procedures to rejuvenate the eye area?
Men and women of all ages may experience concerns relating to their eye appearance. Both genetics and aging can cause considerable changes to the eye area. Three main sub categories exist to classify these concerns:
- Under Eye Bags : The dreaded dark circles just below the lower eyelid. These can be temporarily caused by stress, poor sleep, and diet in younger individuals. In older people, collagen loss and thinning of the skin lead to the permanent appearance of under eye bags. As we age, the naturally sensitive skin and delicate skin of the under eye thins making the fine blood vessels beneath the skin visible, which causes dark shadows and under eye puffiness.
- Crow’s Feet : The fine lines on the outer corners of eyes where the eyelids meet (the lateral canthi). They are usually caused by collagen breakdown and the cumulative effects of daily use.
- Heavy Brow: Excessive prominence of the superciliary arch (the portion of the frontal bone that creates the brow) leads to a protruding brow appearance. It can be caused by a genetic predisposition (note the brow is naturally more prominent in men than women), or can develop as aging skin and muscle loses tone which leads to sagging.
The Anatomy of the Eye
What can you expect from eye rejuvenation procedures?
Eye rejuvenation procedures can be both surgical and non surgical. An invasive surgical procedure like a blepharoplasty or a brow lift will have more permanent and far reaching results. Temporary, minimally invasive injections are generally less expensive and still effective, but may not provide the same impact.
Surgical Cosmetic Procedures
- Blepharoplasty: The umbrella term to describe surgical corrections to the upper eyelid or lower eyelid. There are numerous surgical approaches to these procedures dependent on a candidate’s unique needs.
- Brow Lift: Is the process of correcting a heavy brow by altering internal musculature and skin positioning.
Non-Surgical Cosmetic Procedures
- Neurotoxin Injections: Botox®, Dysport®, Jeuveau®, and Xeomin® act as a temporary muscle paralytic agent to 'freeze' facial muscles (including crow's feet) into the desired smoothness and position.
- Dermal Fillers: Augment the volume of the under eye area to change the overall aesthetic upper third of the face.
Both surgical and non-surgical options will benefit those wishing to alter their eye/brow appearance. A surgical option will be permanent, but invasive, necessitating weeks to months of recovery. A non-surgical option will be temporary and require maintenance, but it will also allow candidates to experiment with aesthetics with minimal recovery.
When should you consider an eye rejuvenation procedure?
In the case of a genetically heavy brow individuals may consider pursuing treatment once they reach adulthood (i.e. finish growing). For those who have noticed under eye bags, crow’s feet, or a heavy brow resulting from aging and use, anytime they are in generally good health and able to accommodate appropriate recovery time is ideal.
Why should you consider procedures to rejuvenate the area around the eye?
As with most cosmetic procedures, the decision to pursue a procedure is a personal choice. Unfortunately home remedies like cold compresses, silk pillowcases, vitamin C, tea bags, eye creams, and eye makeups can only provide temporary solutions. The enhancements to general appearance and personal confidence of an eye procedure, surgical or non-surgical, make pursuing treatments a desirable choice for many candidates.
Blepharoplasty Procedures
Lower eyelid blepharoplasty is a surgical procedure that can improve the appearance of aging and tired-looking eyes through repositioning of fat, or both skin and fat depending on the approach.
- Lower Eyelid Blepharoplasty Transconjunctival Approach
- Overview: Ideal for candidates who require a less invasive approach as they do not have sagging skin. Involves small incisions under local anesthesia in the lower eyelid to access underlying fat tissue. Fat is repositioned or removed to restore under eye fullness. No sutures are used.
- Cost: $2,000 - $7,000
- Recovery & Results: This procedure is permanent. Eyelids will be swollen and discolored for 10 to 14 days. Full activity can be resumed after one month.
- Lower Eyelid Blepharoplasty Transcutaneous Approach
- Overview: This procedure is more invasive than the Transconjunctival Approach. Under local anesthesia incisions are made under the eyelashes, and skin, fat, and muscle is altered or removed as needed. Sutures are used to close the incision.
- Cost: $2,000 - $4,000
- Recovery & Results: A permanent procedure. Eyelids and the under eye area will be tender, discolored, and swollen for about two weeks. All activities can be resumed after one month.
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Brow Lift Procedures
A brow lift procedure allows for the surgical correction of a heavy brow improving the appearance of aging and tired-looking eyes and forehead/brow appearance.
- Combination Mid-Brow Incision with Endoscopic Brow Lift
- Overview: Performed under general anesthesia with incisions made at the midbrow. An endoscope is used to visualize muscles, fat, and internal skin which is excised or repositioned as needed.
- Cost: $4,000 - $7,000
- Recovery & Results: A permanent procedure. The incision will cause tenderness and swelling which will heal within two weeks. Full recovery will take place over a few weeks to months.
- Coronal Brow Lift
- Overview: A surgical incision is made from ear to ear along the hairline under general anesthesia. Skin, fat, and muscle is then excised or repositioned.
- Cost: $10,500 - $14,000
- Recovery & Results: This produces permanent results. Sutures and the drain will be removed within one week. Swelling and pain will be present for about two weeks. Complete recovery can take several months.
- Direct Brow Lift
- Overview: Ideal for candidates who require alterations to deeper structures for functional corrections. Incisions are made under general anesthesia above the eyebrows for precise manipulation of tissues.
- Cost: $3,700 - $4,000
- Recovery & Results: A permanent procedure. Sutures are removed within a week. Bruising and swelling resolves within two weeks, and full recovery occurs within a few weeks to months.
- Endoscopic Brow Lift
- Overview: Several small incisions are made within the hairline under general anesthesia with insertion of an endoscope (lighted camera) to visualize internal structures.
- Cost: $3,700 - $3,800
- Recovery & Results: A less invasive permanent surgical procedure. Initial recovery occurs within 10 to 14 days. Full recovery will take weeks to months.
- Pretrichial Brow Lift
- Overview: The incision for this procedure is made at or just in front of the hairline rather than within it. The skin, fat, and muscle is then altered and repositioned.
- Cost: $2,000 - $3,000
- Recovery & Results: A permanent procedure. Sutures and drain removed after one week. Bruising and pain will resolve within about two weeks. Full recovery occurs over months.
- Traditional MidForehead Brow Lift
- Overview: An incision is made just above the indentation created by the nose between the eyes. Skin, fat, and muscle is then excised or repositioned as needed.
- Cost: $4,000 - $7,000
- Recovery & Results: A permanent procedure. Swelling and bruising resolves within one to two weeks, and full activities can be resumed after two weeks. Complete recovery is seen within months.
Non-Surgical Eye Rejuvenation Procedures
Fillers and injections provide temporary, minimal, invasive solutions for patients with less extensive concerns. Injectables and fillers can address under eye bags, crow’s feet, and a heavy brow. These procedures typically have little to no recovery.
- Neurotoxin Injections
- Overview: Injections of botulinum toxin (Botox® and the like) freeze muscles into a more desirable position smoothing fine lines and wrinkles.
- Cost: $200 - $1,400
- Recovery & Results: Temporary results with maintenance required every three months. All activities can be resumed the same day with minimal soreness.
- Chemical Brow Lift
- Overview: Botox® is strategically injected into forehead musculature to relax the muscles and smooth wrinkles and brow furrows.
- Cost: $800 - $4,000
- Recovery & Results: Temporary results with maintenance every two months. Minimal down time, and patients can return to work the same day.
- Carboxy Therapy
- Overview: Utilizes injections of carbon dioxide gas to stimulate blood flow and oxygen delivery enhancing cellular nourishment and repair.
- Cost: $100 - $200
- Recovery & Results: Temporary results which will become noticeable after four to eight weeks of treatments. Maintenance needed every four to six weeks. There are minimal side effects.
- Under Eye Filler
- Overview: Hyaluronic acid (HA)-based fillers, like Restylane® or Juvederm®, are injected to alleviate the appearance of dark circles and under eye bags.
- Cost: $800 - $5,000
- Recovery & Results: Temporary results lasting six months to a year. Patients should limit strenuous activity and sun exposure for about three days.
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