Guest Post: How Do You Know What Eye Treatment is Right For You?

By Dr. Sanaz Harirchian for

Your eyes are one of the most expressive features of your face, they communicate emotion, and are a central focus of your face. Yet too many of us feel that our eyes are making us look tired or aged. While surgery is sometimes used to rejuvenate the eyes, nonsurgical treatments such as fillers, botox, and lasers can also be great treatments. The best treatment depends on the underlying cause of your aging eyes, your lifestyle and preferences. So how do you know what is best for you?

A youthful face is full and has lots of volume, without significant wrinkles or excess skin. This aged appearance of the eyes can be the result of several reasons, including extra skin, protruding fat, and loss of volume. As we age, the skin loses collagen and elastin, and becomes thinner, and falls with gravity. 

Upper Eyelid Surgery (blepharoplasty). In the upper eyelid, this can result in extra skin hanging over the eyelids, which makes the eyes look smaller. The best treatment for this problem is a surgical eyelid lift, called an upper blepharoplasty. An upper blepharoplasty involves removing a conservative amount of upper eyelid skin, to expose the upper eyelid. This makes the eyes look larger and more youthful.

Skin Resurfacing Techniques (chemical peels, microneedling and lasers). In the lower eyelid, the changes in the skin can produce fine lines and wrinkles. If the texture and quality of your skin in your lower eyelid is your only concern, then a non surgical approach of skin resurfacing would be the treatment I recommend. Skin resurfacing treatments produce new skin and the best skin treatment should be recommended by your physician depending on how deep the wrinkles are, and how much downtime the patient has. Deeper skin resurfacing treatments, such as with the fractional Co2 laser, have better results, but require more recovery time.

Botox™. If the wrinkles are on the outer corners of the eyelid or “crow’s feet area,” the best treatment is a neuromodulator, such as Botox™. Botox™ temporarily weakens the muscle, and is great for treating wrinkles that are from muscle movement, such as in the “crow’s feet” and forehead. I also frequently use Botox™ to give a nonsurgical brow lift in the corner of the brow. This is great for people who want a little lift to the sides of their eyebrows.

Other causes of aging eyes include protruding eyelid fat. With age, the orbital septum, which is a membranous sheet in the eye, can weaken, allowing eyelid fat to protrude out. This can create “bags” under the eyes or in the upper eyelid. A very common concern I see people express is the hollowing or “tear troughs” that they see under their eyes. This hollow is a shadow created by a either

1.)   Too much fat pooching above the hollow, creating a shadow below it.


2.)   Too little volume in the area of the hollow, creating a shadow.


Lower Eyelid Surgery (blepharoplasty). If the bags under the eyes are from herniated fat, then usually surgery (a lower eyelid blepharoplasty) is the best solution. I use a surgical technique where I move the puffy fat during surgery to fill the hollow to make a beautiful smooth eyelid/cheek junction.

Fillers. If the bags under the eyes are from lack of volume, then hyaluronic acid fillers are a great solution.  Hyaluronic acid filler is a gel-like substance that inflates hollow areas of the face. It is injected underneath the skin, and the results are seen immediately.

It is 2016, you should be proud of your eyes, let them be the sparkle and warmth in your face, rather than something making you feel tired or old. There are many different options for rejuvenating your eyes, pinpoint the underlying reasons for the areas you want to improve so you can figure out which solution is best for you.

Sanaz Harirchian, MD is a board certified; Ivy-League educated fellowship trained facial plastic surgeon. Her practice is dedicated to aesthetic and reconstructive surgery of the face, with a focus on rhinoplasty, eyelid, and facelift surgery. In addition to her skills in plastic surgery, Dr. Harirchian is an avid author, educator and researcher. Her practice is located in Houston, TX. Her work and can follow her work via her website and consistently updated social platforms.

Posted on February 9, 2016 .