What about those wrinkles around my eyes?

I had a friend when I was younger (ahhh, remember those days?) who went to a place with a bouncer (ie you had to be 21) and she had no ID.  She was around age 30 at the time, so she didn’t think “Oh my. Someone may card me.”  But the bouncer wasn’t going to let her go in.  Then she said, “Really? I am 30!” So he did two things: 1. He looked at her hands, and 2. He looked at her eyes.

I love stories like that.  The common world wisdom, the stuff grandmother’s advice and old wives tales are made of.

Eyes show your age.  They are usually the first place on the face which need to be tinkered with.  Not all things to improve the eyes are surgical.

Nonsurgical things:

• BOTOX. Crows feet are one of the first things to crop up.  I heard a story of a medical student who wouldn’t smile- he wanted to become a plastic surgeon and didn’t want to form any wrinkles.  Egads.  Don’t do that! Just use botox.  This does not affect your use of your eyes.  The muscle we treat for crows feet is not one which causes you to move your eye to see or open your eye.  You will still have “smiling eyes.”  You won’t look like some kind of weird robot.  Botox just keeps your wrinkle from going all the way down your cheek when you smile.
• Skin care.  A lot of how much you wrinkle and how deep it is depends on your natural skin and anatomy: how thin is your skin? is it sundamaged? Did you/do you smoke? Do you have fat on your face?How old are you?  You can’t change your age and genetics.  You can practice good skin care to delay aging: antioxidants like Vitamin C and E, Retin A products (medical grade, not over the counter), sunscreen (love the clear zinc ones).
• Skin fillers. Skin fillers like Juvederm, Restylane, and Sculptra can be used around the eye to fill the tissue.  Some of the wrinkling around the eye is not due to poor skin quality or muscle use, it is due to loss of fat under the skin and erosion of your bone.  Adding volume helps fill the area to give a more youthful appearance.

Once you have too much excess skin, hanging skin, or bulging fat, then you get into surgical options.

• Upper eyelid surgery, “blepharoplasty“: This removes excess skin and fat. Barely visible scar. Surgery can be done under local anesthesia.
• Lower eyelid surgery, “lower lid blepharoplasty“: This removes excess skin under the lower eyelid.  I usually redrape the fat- move it, as opposed to taking it out- to give a more youthful look.  I usually also tighen the lower lid as well to prevent eyelid droop.  Scar goes under the lash line.  Can be done under local anesthesia.
• Browlift.  This can be endoscopically or open.  This will raise your eyebrow position to a higher level to open up your eye.  Wrinkles of the forehead will improve.

So :

Start with preventative medicine: sunscreen, antioxidants, and Retin A products.  Move up to Botox when you need to- usually in your 30s or 40s. Then surgery when you need the extra bit: eyelid surgery starts in late 30s and 40s.

But keep smiling! Nothing makes you look prettier than that.