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

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 RF

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.

Hyaluronic acid

Dr Pagkalos uses a combination of hyaluronic acids to achieve a natural periorbital rejuvenation: Juvederm® Volift™, Restylane® Lyft™, Restylane® Eyelight™ and Juverm® Volbella™. The reason behind the use of so many different types of fillers injected in such a small area is the particular anatomy of the region and the amount of stress put in the skin due to eye movement and facial expressions.

HA is the keystone of periorbital rejuvenation since it can simultaneously lift the mid face, restore volume loss, support anatomical compartments, reduce dark circles and minimize under-eye bags. Through an evolution of the techniques introduced in the early 2020s, Dr Pagkalos can practically treat any degree of around-the-eyes aging and can achieve results that are close to those of a surgical procedure.

Although mid face lift and eyelid surgery is the ultimate solution to face aging, nonsurgical periorbital rejuvenation can achieve comparable results without the risks and the recovery time associated with surgery. Dr Pagkalos is considered as one of the experts in nonsurgical periorbital rejuvenation.