The periorbital facial subunit consists of eyebrows, upper and lower eyelids, glabellar region and the pericanthal area. It is one of the first regions to reveal signs of aging and plays an important role in overall facial appearance. Environmental factors (such as sun exposure, ultraviolet light, dry air or sea water) as well as genetic predisposition and habits (smoking, lack of sleep, substance abuse) can dramatically accelerate the aging process in the area around the eyes.

Aging skin is characterized by the appearance of fine wrinkles, rough and uneven texture, dryness and changes in pigmentation. Volume loss along with animation lines add to the aging appearance with dimples, hollowness and volume irregularities.

Although surgery provides the ultimate long term results, modern anti-aging offers plastic surgeons a variety of nonsurgical options that allows to sufficiently treat the periorbital area and postpone surgery.

The nonsurgical periorbital rejuvenation is achieved by a combination of treatments:

• Mechanical and chemical skin resurfacing
• Laser or Radiofrequency devices
• Mesotherapy
• BTX
• Fillers (Hyaluronic acid)

Skin resurfacing aims at reducing the depth of fine wrinkles and improving skin elasticity and skin texture. Skin resurfacing removes the damaged outer layers of skin and encourages new collagen growth in the inner layers. In younger patients with minimum skin damage, skin resurfacing can be a stand-alone treatment.

Laser and Radiofrequency (RF) devices are popular cosmetic procedures that use heat to promote production of collagen and elastin, leading to firm skin. Since skin around the eyes is relatively thin and sensitive, one should pay attention to the amount of energy applied in order to avoid complications and prolonged healing times. Furthermore, heat accelerates Hyaluronic acid absorption and therefore, Laser or RF treatments should be completed before the onset of fillers. 

There is nowadays a vast amount of eye-specific mesotherapy solutions and protocols that, if chosen correctly, can significantly improve skin quality and reduce dark circles, fine wrinkles and under eye edema. Mesotherapies however should be considered as an ongoing treatment; repeated sessions are mandatory to achieve and maintain results.

Botox (BTX) is the ultimate nonsurgical way to relax muscles, lift eyebrows and reduce crow’s feet. When performed correctly, it can dramatically rejuvenate the periorbital area and give patients a fresh, young look. In order to maintain results, BTX should be repeated 2 or 3 times a year.