You can usually tell someone’s age from his or her eyes. We all start noticing changes in our eyes in the mid thirties. This is when the crow’s feet appear, the upper lid skin starts slightly hanging over the crease, the lower lid fat starts bulging and the area between the lower lid and the upper cheek starts hollowing. These changes, although subtle, they progress as we get older. Obviously we don’t all age the same way or to the same degree. For example, those of us who are blessed with nice cheekbones maintain a more youthful look of their lower lids than those who aren’t.

There are several non-surgical methods of eye rejuvenation. The combination of Botox and fillers can produce subtle, vibrant, and natural results through elevating and adjusting the level of the brows, softening the crow’s feet wrinkles and enhancing the volume around the eye. Lasers can tighten the upper and lower lid skin and treat fine wrinkles. Several cosmetic and skin care products help reduce puffiness and improve the under eye dark circles. So when is surgery necessary?

Generally speaking, it is the laxity of the skin and the degree of fat protrusion (fat bags) that determine the need for eyelid surgery. Although these two problems can be improved and camouflaged with fillers, it becomes more challenging to do so as they worsen. More filler will be needed and the results are not permanent. Surgery provides a more permanent solution and is more effective in handling excess skin and in redistributing fat from less to more desirable locations.

Does this mean that surgery is only necessary in older patients? The answer is no. Some of these changes, as mentioned before, start appearing at an early age to a varying degree and depending on their severity and the patient’s goals, surgical treatment could be needed. Learn more about eyelid surgery.