Thank you for your question!
You submitted a photo and you’re asking: is there anything that you can do for your
under eye area? Well, I can certainly provide you with some guidance based on your photo
alone. I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic
and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years. The training
of oculoplastic surgery is a super specialty after full-training in eye surgery and so
it is an area that I’ve been in focus with in the past 20 years to help people improve
the aesthetics of their under eye area. So I’ll give you a sense of how I do an analysis
when someone like yourself comes to our practice and asks the very same question.
First, I look for one of the most common reasons for concerns about the under eye area and
that’s puffiness. And what does that mean? Well, puffiness under the eyes that is constant
and doesn’t go away regardless of sleep or management of allergies and sinuses is
usually caused by something called lower eyelid fat prolapse. Lower eyelid fat prolapse means
the fat around the eyes that is normally there, pushes forward and creates this undesirable
bulge and makes someone look like their always tired.
The other elements of the under eye area that I look at has also to do with skin quality.
It is something that I realized years ago that when we help patients with the puffiness
they immediately was also concerned, once that was resolved, with skin quality. So in
terms of skin quality and in terms of puffiness, what I see as an opportunity for you, the
under eye area where there is lower eyelid fat prolapse, I would perform a procedure
called lower eyelid transconjunctival blepharoplasty. What that means is that I would address the
fat pockets from behind the eyelid and this procedure is done under local anesthesia with
LITE™ IV sedation. Basically means that you don’t have to go under general anesthesia
and we perform this in our facilities within our own practice. So that way the person doesn’t
have to go into a hospital or surgery center. And essentially, the facilities that are certified
by the Joint Commission which is the same body that certifies the safety in hospital.
That is exactly what I would do for someone like yourself in our practice.
Now to help with skin quality, it is routine for us to do two things at the time of the
procedure for someone with your skin type and that is to help the wrinkles, I would
do something called fractional CO2 laser. Fractional CO2 laser takes off partially some
of the top layers of the skin so essentially getting the benefit of resurfacing and time,
delivering thermal energy to the backbone of the skin called the dermis. And so, you
get a certain type of skin tightening.
We also will use something called platelet-rich plasma. Platelet-rich plasma is derived from
your own blood and it stimulates collagen and blood supply. Basically, what we’re
doing is we’re using the same elements of the blood that’s needed for wound healing
to stimulate a wound healing response in a way that helps improve skin quality. It’s
been very successful for us. We, use PRP or platelet-rich plasma routinely for under eye
dark circles and skin quality improvement with laser, without laser as well as for acne
scars, for fine lines and wrinkles, scars and in addition combined with extracellular
matrix for hair loss in a treatment we call Hair Regeneration. So we have a lot of experience
with platelet-rich plasma. I think that combination would be likely in my hands to yield a very
significant improvement for someone like yourself.
Now that being said, I think it’s important now to have an actual consultation with qualified
and experienced doctors. My bias is finding specialists, people who specialize in cosmetic
eyelid surgery and learning about your options and learning about the different styles and
look at before and afters and learn more about your individual doctor’s style. It’s very
easy to sometimes commoditize these procedures but I could promise you, every doctor has
their own approach and own style and you would have a slightly different result even if it
looks straightforward from a first glance.
So I hope that was helpful, I wish you the best of luck and thank you for your question!