Throughout history, the eyes have held us in captivation for their indications of emotion, youth and health.
We’ve been mesmerised by Sophia Loren’s, Elizabeth Taylor’s, Angelina Jolie’s, Scarlett Johansen’s and even the Mona Lisa’s – our fascination with beautiful eyes has been a primary point of reference for beauty, both throughout history and in our contemporary beauty culture.
Several studies show the eyes are the most important facial feature that other people use to determine your age, level of fatigue and even overall health.
Such studies have shown the eyes are most focused on during conversations on first meeting, revealing that factors such as the degree of wrinkling, poor skin texture and upper eyelid “hooding” indicate poor health and lifestyle to the beholder.
Similarly, it has been found that people with bloodshot eyes are considered sadder, unhealthier and less attractive than people whose eye whites are unstained in colour.
With the effects of ageing taking their toll, the anatomy that frames the eyes experiences a series of changes that can make recapturing a transfixing gaze difficult without a helping hand.
We take a look at the ageing process and some of the stellar procedures used to rejuvenate the appearance of the eyes and brighten and illuminate the face.
The ageing process
From skin laxity and thinning to fat depletion and decent, there are many different processes occurring as the eyes age.
In general, there are four things going on that make a person look older: photoageing, dynamic lines, gravity and volume. Photoageing can be treated using laser treatments and peels; dynamic lines can be reduced using muscle relaxants; gravity causes the decent of skin and fat which can be corrected with a surgical “lift”.
Basically, volume disappears from where you want it, and accumulates where you don’t want it. Unfortunately these processes are all acting together around eye area and are also affected by genetics and lifestyle.
When these categories are more specifically applied to the eyes, very specific and delicate changes can be seen to occur during the ageing process. The muscle layer beneath the skin starts to lose its tone with age, the fat of the eyelid bulges forward to cause a dark shadow, the cheeks begin to shrink, leaving a groove-like valley known as the tear trough, and the brows descend.
These changes often lead people to mention that you look tired when you are not, and make you look like your parents long before you thought you would (eek!).
It is vital to appreciate that the loss of skin elasticity and turgor that occur in ageing contribute significantly to periocular and facial ageing.
Because of this complex ageing process, there are many important aspects in ensuring the right blepharoplasty options are chosen to deliver the best results for each individual.
Upper blepharoplasty
Upper eyelid surgery is known among surgeons to be more straightforward than lower eyelid surgery and is well suited to those with excess skin that creates a hooded effect over the eyes.
Typically, the procedure involves surgically removing this excess skin to create a more ‘open’ appearance in the eye area, revealing the contour of the brow and inner eyelid crease. In some cases the fat pockets around the eye need to be repositioned during surgery, but this depends on the patient.
Upper eyelid surgery is usually approached from the skin crease in the outer surface of the eyelid – five to 10mm above the lash line. Rejuvenation of the upper eyelid may often involve lifting or supporting the brow at the same time. This can be performed by incisions around the hairline. As well, the brow can be supported more directly by using the same incision as used for the upper lid blepharoplasty. Upper blepharoplasty procedures can produce dramatic results for those suited to the procedure, providing a very noticeable improvement to the face overall.
Lower blepharoplasty
There are much bigger differences in approaches to the lower eyelid than there are to the upper and can sometimes require a combination of surgery, filler and laser to give the best result.
A transconjunctival blepharoplasty involves making an incision on the inside of the lower eyelid to access the tissues of the eyelid. The orbital fat can be repositioned or removed from this approach. When the fat is repositioned, it is moved into the area of the orbital rim depression to reduce the fullness of the lid and the depth of the orbital rim groove. This technique improves the appearance of the dark circle around the eye, with minimal effect on the shape of the eye while maintaining a natural-looking appearance.
Brows
The eyebrow area can be especially influential in the appearance of ageing eyes, which can sometimes call for both surgical and non-surgical options to enhance the brow and rejuvenate the eyes.
The brows frame the eyes and when they are drooping and deflated they can make a person tired and older than they are. The brows also convey expression, so when the brows droop they can make you look angry, sad or even sinister involuntarily. Something as simple as anti-wrinkle injections can safely and effectively alter an angry or heavy brow appearance, and filler injections strategically placed in a sagging eyebrow or hollow temples can also enhance the eye area.
Brow descent can be managed with a variety of surgical interventions, from minor procedures such as thread lifting to more substantial surgery such as an endoscopic brow lift (keyhole surgery to lift the brow) or bicoronal lift (surgical repositioning of the scalp).
Surgical brow lifting procedures provide a permanent option for those with excessive brow descent and can work to provide total upper facial rejuvenation.
Combination rejuvenation
More often than not, the source of dull, tired-looking eyes is the quality of the skin around them. A chemical peel or laser resurfacing treatment is often combined with surgical and non-surgical options to restore the skin underneath the eyes, targeting pigmentation, sun-damage and poor-textured skin. Safety precautions are employed to ensure the eye is not damaged during such treatments, typically with the use of protective contact lenses.
Thread lifting can also be used in combination with non-surgical eye rejuvenation treatments and involves the insertion of tiny barbs which adhere to the skin from underneath to lift and tighten the skin. Modern thread lifting procedures involve the use of re-absorbable threads, which dissolve over time and leave a framework of collagen fibres to secure the lifted effect.
