Facial beauty, specifically of the periorbital complex, is one the most important component of physical attractiveness, non-verbal communication, as well as a reflective of chronological age. Conventionally, rejuvenation of the eye area meant the need for invasive surgical treatments, but in recent years, minimally and non-invasive procedures have increasingly become the first-line treatment option; although the need for surgical intervention may be necessary for advanced cases. In general, non-surgical procedures include, but not limited to, the use of botulinum toxin, dermal filler injections, laser and chemical peels, laser skin resurfacing, microdermabrasion and intense pulsed light photo-rejuvenation.
Ageing of the Eye
Image credit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560162/
As we age, our bony layer undergoes a reabsorption of the skeleton, mostly in the orbital, periorbital, malar, submalar, and mandibular areas as the natural level of dermal hyaluronans diminishes. Treating of this region is made even more challenging with the complex anatomy and dynamic underlying muscles of facial expressions in this particular region.
Additionally, fat compartments in the deep supraperiosteal layer, gradually lose volume in the lateral and medial suborbicularis oculi fat compartment, the deep medial cheek compartment, and the chin fat compartments; whilst in the superficial subcutaneous layer, volume loss occurs in the lateral compartments - both in their temporal and preauricular districts and to a lesser extent, in the middle and medial fat compartments of the superficial cheek fat pad.
Correcting Deformities at the Eye Area
It is known that the general bone and fat ageing process progresses in a rather predictable fashion, thus, the restoration of volumes in the face and eye areas can be expected to follow a quite standardised sequence; making it useful in targeting the different regions of evolving atrophy to achieve optimal volumetric rejuvenation, especially when addressing eye-area deformities.
Despite the many techniques and methods available to correct deformities at the eye area, the use of botulinum toxins and fillers is one of the most common approach offered to patients as a quick and minimally-invasive option for eye rejuvenation.
While some studies have suggested the insolation of neurotoxins to ameliorate dynamic rhytids in younger patients as an alternative technique, it is not quite sufficient to address the static changes caused by volume loss in the dermis and underlying soft tissue. Therefore, the use of botulinum toxin in combination with dermal fillers is, and has been, a more viable option for non-invasive rejuvenation in patients with deep static rhytids. When used in combination, neurotoxins also have the added benefit of increasing the longevity of fillers.
On top of using the right materials and tools, correcting deformities in the eye area requires a practitioner to precisely select the area of injection according to the anatomy as well as applying sound strategies of injection and techniques - only then, can a practitioner effectively deliver optimal results in patients.
Non-Surgical Procedures for Eye Rejuvenation - Benefits of Fillers
Dermal fillers have revolutionized the field of cosmetic dermatology and have been used effectively in the periorbital area for more than 20 years. With the ageing of baby boomers, dermal fillers have also become one of the most sought-after rejuvenation procedures as they offer a youthful, three-dimensional look with minimal downtime. Its gaining popularity can be attributed to the increased attention by the media and the availability of a wide array of filler materials available at prices more affordable than before. The use of fillers for soft tissue augmentation with the synergistic use of botulinum toxin and a variety of complementary procedures has become the mantra for non-surgical rejuvenation.
In restoring fullness and volume, especially for periorbital rejuvenation and other facial areas, hyaluronic acid (HA) products are one of the most, if not the most, commonly used filler. As a naturally occurring polysaccharide found in the connective tissue of all living species, HA is generally very well tolerated by many, and its ability to be dissolved with hyaluronidase makes it one of the most preferred choice of filler by both patients and physicians alike.
Not only do fillers have the ability to restore and add volume to sunken/hollowed areas, when injected in targeted areas, it can also help reduce the appearance of dark eye circles by hydrating the area and stretching the skin. Fillers injected under the eye can also greatly reduce dark shadows by plumping up the hollow areas around the eyes and the versatility of fillers can help improve skin texture and reduce fine lines.
Some research have also shown that with repeated injections, fillers may help stimulate the body's own natural production of collagen, which in turn reduces the number of lines and wrinkles in the injected area. Along with the above, other benefits of using fillers for non-surgical eye rejuvenation are:
Reduced dark eye circles
Reduction of eye bags
Improve fine lines and wrinkles
Brighter and more youthful looking eyes
With fillers become increasingly common as an aesthetic treatment for several cosmetic problems, it is, hence, important that a treating physician be aware of the different techniques of administration and their possible side effects.
Non-Surgical Blepharoplasty: Restoring Volume using Fillers
Often than not, correcting volume loss in sunken/hollowed areas is one of the most commonly requested non-surgical procedure when it comes to eye rejuvenation. The concept of using fillers, combined with other non-surgical techniques and applied surgical-based logics, can allow a physician to get optimal results with minimal downtime and good longevity.
Due to the anatomy and dynamics of the periorbital region, treatment of this area is particularly vulnerable and complex. Botulinum toxins and fillers, especially when used in combination, can offer an excellent approach to minimally-invasive rejuvenation of this area, but what is even more so important, is to consider their use within the context of a comprehensive approach to rejuvenation of the treatment area.
In the past, fillers are used for superficial treatments based on dermatologic approach, and has only yielded short-lived results. Today, however, they are no longer used just for addressing superficial conditions but also used to help restore volume based on surgical concepts and maintenance of results. By restoring volume in hollowed areas, a practitioner can limit the impact of sagging with some added lifting effects. Other techniques including PRP injection, laser resurfacing and photo-rejuvention may be used as indicated for each individual patient and a combination approach is often recommended for optimal results.
As with any procedure, a thorough understanding of the underlying anatomy, sound injection techniques and knowledge in managing complications coupled with the ability to promptly recognise and treat these complications is essential in minimizing any adverse impacts so as to achieve optimal results.
This week, IFAAS faculty, Australia-based Dr. Matthew Holman demonstrates his exclusive techniques on How to Restore Volume in Tear Trough using Fillers. This technique is also taught at our upcoming Advanced Non-Surgical Combination Therapy for Total Eye Rejuvenation Hands-On Master Class happening in Sydney, Australia on 11 August 2019:
Hope you have enjoyed the article & video! Stay tuned for our future posts about more techniques and information related to our advanced aesthetic and cosmetic training courses!
Learn the Latest and Most Cutting Edge Techniques in Advanced Non-Surgical Combination Therapies for Total Eye Rejuvenation at our IFAAS Hands-On Master Class Trainings Now!
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August 11, 2019: Sydney, Australia
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August 10, 2019: Sydney, Australia
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