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Happily there are many preventative steps we can take to prevent eyelid aging changes, and if you already have aging eyes there are many exciting new non-surgical methods available to reverse eyelid aging changes.

The earliest eyelid aging changes are eyelid wrinkles called crow’s feet which we see on the corner of our eyelids on the cheek when we smile. Later these wrinkles extend across the lower eyelid and up into the upper eyelid. Later the upper eyelid skin becomes lax and begins to sag or droop and eventually covers the beautiful upper eyelid fold and begins to form an eyelid hood or eye hood which eventually can compress the upper eyelashes and obstruct vision. Eye hoods or eyelid hooding can also be made worse by the descent of the sagging eyebrow.

The lower eyelid also becomes lax and as a result, normal fat beneath the eyelid protrudes or pushes out on the eyelid and creates eye bags or eyelid bags or puffy eyes. This protruding lower eyelid tissue creates a shadow in the normal depression below the eyelid and creates the dark circles under the eye.

Fortunately there are many things we can do to prevent these eyelid aging changes before they occur or reverse these changes early without surgery. If however advanced eyelid aging changes occur, there are excellent modern laser and surgical eyelid rejuvenation procedures available to restore the eyelid to a youthful appearance.

Prevention of Eyelid Aging

Sun block, wrap around sun glasses, and general sun protection are essential eyelid aging prevention techniques, especially in the south, southwest and west where sun exposure is greatest and outdoor activities are so common. A healthy diet and exercise help prevent premature skin aging and tired eyes. Botox prevents crow’s feet. A good anti-aging skin cream like Retin A or vitamin C can help prevent and reverse eyelid skin aging and eyelid wrinkles.

Non-surgical eyelid rejuvenation

Exfoliation of eyelid skin, stimulation of new collagen formation in sun damaged eyelid skin, and tightening of eyelid skin can all be achieved non-surgically and can correct early eyelid aging changes and tired eyes. Topical Retin A, microdrmabrasion and Dermasound are good non-surgical eyelid rejuvenation techniques. For more severe eyelid aging, laser skin rejuvenation with newer less intensive eyelid laser skin peeling techniques such as the activefx laser skin peel or the microlaserpeel, or the lux2940 microfractional laser peel can exfoliate and tighten eyelid skin and remove eyelid wrinkles.

Surgical Eyelid rejuvenation

Modern eyelid rejuvenation surgery utilizes the laser and revolutionary new blepharoplasty techniques to rejuvenate the aging eyelid with minimal or no scarring and can correct tired eyes while preserving the beautiful eyelid shape. Surgical lower eyelid rejuvenation utilizes a laser incision on the inside of the lower eyelid through the pink portion of the eyelid called a transconjunctival blepharoplasty. During this procedure the eyelid fat is repositioned to remove the eye bag without creating a hollow eyelid appearance. Dark circles under the eyes are removed by a procedure called the arcus marginalis release, all with no scar. Upper eyelid hooding or eye hoods are also removed with the laser with virtually no bleeding, thus less bruising, quicker recovery and a small scar that is invisible when the eye is open. If wrinkles and sun damage of the eyelid are severe a new more gentle Lux 2940 microfractional laser skin peel can be done to smooth and freshen the eyelid skin for total eyelid rejuvenation.

With prevention, eyelid aging can be forestalled and early eyelid nagging can be treated with simple painless non-surgical high tech methods. Once eyelid aging has occurred remarkable truly revolutionary laser eyelid rejuvenation techniques are available to correct tired eyes, restore a youthful, open, alert, bright look to the eyes, the window to our soul.

To learn more about eyelid aging prevention, modern eyelid rejuvenation, and facial rejuvenation, read Save Your Face or contact me.

Thank you,

Dr Seckel,

Boston, Massachusetts

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Eye bags and puffy eyes are caused by a structural problem beneath the eyelid, and eye creams just cannot reach the cause of the eye bag or puffy eye and thus cannot correct eye bags or puffy eyes.

Nearly everyone over 30 begins to notice eye bags, puffy eyes and dark circles under their eyes, Billions of dollars are spent each year on skin creams to remove eye bags, puffy eyes and dark circles under the eyes and plastic surgery, called blepharoplasty which is done to remove eye bags and puffy eyes is the third most common plastic surgery operation done in the United States.

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What Causes Eye Bags, Puffy Eyes and Dark Circles under the Eyes?

Eye bags, also called eyelid bags, puffy eyes, tired eyes, and dark circles under the eyes, are caused by protrusion or herniation of the fat which lies beneath the eyelid and which normally is held directly beneath the eyeball. The reason the fat is beneath the eyeball is that it acts as a shock absorber preventing the eyeball from coming into contact with the bone of the eye socket. The eyelid is positioned directly over this supporting fat pad and holds the fat in place directly below the eyeball so that the fat can serve its function.

The problem of eye bags and puffy eyes occurs as we age because as the skin of the eyelid ages it loosens, becomes less elastic, and begins to sag and lose tone. As the eyelid loses tone it cannot hold the fat within the bony orbit or eye socket beneath the eyeball, and the fat pushes forward against the undersurface of the weakened eyelid and creates the eye bag , puffy eye, or eyelid bag.

This pushing forward on the eyelid and creating an eye bag, eyelid bag or puffy eye is technically called fatty orbital herniation, because the fat herniates or protrudes from the bony orbit or eye socket and creates a bulge or eye bag or puffy eye. To herniate means to project through an abnormal opening, like the bulge produced by a hernia on the lower abdomen. Eye bags or puffy eyes are a hernia of the eyelid.

The other eyelid aging sign is called dark circles under the eyes. Technically this is called the tear trough deformity and is caused by a tethering of the dark circle skin from underneath the eyelid skin by a structure called the arcus marginalis, which is discussed below. The dark circles under the eyes are essentially a shadow created by the overhanging eye bag or puffy eyelid.

How Are Eye Bags and Puffy Eyes Removed Traditionally?

Eye bag removal has traditionally been done with a plastic surgery operation called a blepharoplasty. During the traditional eye bag surgery the plastic surgeon made an incision on the lower eyelid just beneath the eye lashes, exposed the underlying fat causing the eye bag or puffy eye, and removed the fat and also removed some of the skin which had been stretched into the eye bag. Although the blepharoplasty does remove the eye bag or puffiness, there are several problems with this traditional eye bag or puffy eye surgery.

First, the incision through the eyelid weakens the eyelid skin and muscle which supports the eyelid and holds the eyelid tight against the eyeball. As a result of weakening of the support for the eyelid, the eyelid often turns down or sags after a lower eyelid blepharoplasty. Technically this is called an ectropion or scleral show, but in lay terms it is referred to as the sad eyed look or hound dog eyes. It is a terrible stigma of the old scalpel blepharoplasty operation. The ectropion can also have serious implications for the eye ball itself. When the ectropion is severe, the eyeball can dry out, develop a corneal ulceration, and threaten the eye. Often corrective surgery called a canthoplasty is required.

Because of these serious complications from traditional eye bag and puffy eye surgery new modern blepharoplasty techniques have been developed to remove eye bags and puffy eyes without damaging the support of the eyelid. The newer, more modern blepharoplasty technique is called a transconjunctival blepharoplasty. The conjunctiva is the pink part of the lower eyelid on the inside of the lower eyelid, and during the transconjunctival blepharoplasty the incision is made on the inside of the lower eyelid and the fat exposed and the tissues tightened. The transconjunctival blepharoplasty can be used to remove eye bags and puffy eyes without damaging the outer supporting eyelid muscle and tissues and thus the eyelid support remains in tact and there is little risk of ectropion or hound dog eyes after removal of the eye bags and puffy eyes.

Remove Eye Bags but Avoid Hollow Eyes and Correct dark Circles Under The Eyes!

Another serious drawback to traditional blepharoplasty for eye bags and puffy eyes is that often the surgeon removes too much of the fat that was causing the eye bag. The result of too much fat removal during blepharoplasty is that after removal of the eye bag the patient is left with a hollow eye appearance. This is a very distressing problem for patients, so distressing that many patients choose to have additional surgery to transplant fat back into the eyelid to correct the hollow eye appearance after eye bag and puffy eye removal.

Newer more modern blepharoplasty techniques for eye bag and puffy eye correction do not remove fat but reposition the fat or graft the fat into a better position to create a more youthful eyelid look and remove dark circles under the eyes. When a person has eye bags and puffy eyes there is almost always a dark circle under the eye directly below the eye bag. These dark circles are called the naso-jugal fold or tear trough deformity and is caused by the attachment of a small structure called the arcus marginalis. The arcus marginalis is attached to the bone of the eye socket and is also attached to the underside of the lower eyelid just below the eye bag. The arcus marginalis holds the lid down or tethers the lower eyelid to the bone right at the dark circle, creating the tear trough deformity, so the upper part of the lower eyelid, the eye bag falls over the dark circle or tear trough, and makes the dark circle shadow worse.

Newer more modern blepharoplasty involves a transconjunctival blepharoplasty, which avoids ectropion, followed by release of the arcus marginalis, which releases the dark circle or tear trough deformity. Next, the protruding eyelid fat is not removed, but the bulging fat is placed beneath the dark circle, to plump the dark circle or tear trough, reduce the shadow, reduce the eye bag and puffy eye and avoid the hollow eye.

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This is a new technique for removal of eye bags, puffy eyes and dark circles under the eyes and not widely practiced by plastic surgeons yet. As always there will be a 10 year delay between this new medical discovery and the adoption of the technique by the majority of surgeons. That is just the way new technology develops in surgery.

Festoons Can Look Worse After Old Style Blepharoplasty for Eye Bags and Puffy Eyes.

A festoon is often mistaken for an eye bag or puffy eye. In fact a festoon is a puffy swelling on the cheek just below the lower eyelid and is not an eye bag or puffy eye as many people think. The festoon is cheek skin and cannot be removed during a blepharoplasty. It is a puffy swelling at the top of the cheek just below the dark circle under the eye just below the eye bag. he technical term for a festoon is a malar bag.

Most people do not understand what a festoon is and mistakenly believe that the festoons can be corrected by the blepharoplasty for eye bags or puffy eyes. In fact, after a blepharoplasty for eye bags or puffy eyes is done, the festoons can look more prominent and make the face look worse!

For many years there was nothing that could be done to remove festoons, however new technology holds promise that we may soon be able to significantly improve festoons. New skin tightening technology called Aluma can help. The Aluma is a radiofrequency device that heats the deep layers of the skin and causes the collagen in the skin to shrink or tighten. The result is that the skin tightens and the skin of the festoon tightens and the festoon is less noticeable.

The Modern Blepharoplasty for Removal of Eye Bags, Puffy Eyes, and Dark Circles Under The Eyes- Transconjunctival laser arcus marginalis release with preservation and repositioning of orbital fat.

I have used the laser exclusively to perform all of my blepharoplasty operations for the past 12 years, over 2300 cases. The new modern way to remove eye bags and puffy eyes is to use the laser to perform a transconjunctival blepharoplasty with arcus marginalis release to release the dark circles under the eyes and correct the tear trough deformity, and fat grafting to plump the dark circle and prevent the hollow eye look. This technique prevents ectropion, sad eyed look, and hound dog eyes and gives the lower eyelid a very young, smooth look with no eye bags and no change in eyelid shape. The results of my experience are published in the Journal Plastic and Reconstructive Surgery. The benefits of using the laser transconjunctival blepharoplasty with Arcus marginalis release and Fat grafting are:

1. No bleeding
2. Minimal bruising
3. quicker recovery
4. No visible scar on the eyelid
5. no change in the beautiful eyelid shape
6. quicker surgery with less anesthesia time
7. Correct the Tear Trough deformity or dark Circle Under the Eye
8. Avoid Hollow Eyes
9. Remove Eye Bags and Puffy Eyes
10. Excellent Results

Add The ActiveFX Laser Peel of The Lower Eyelid for Eyelid Wrinkle Removal and Total Eyelid Rejuvenation

All blepharoplasty procedures for eye bags and puffy eyes still do not totally rejuvenate the lower eyelid unless something is done to correct the eyelid wrinkles, brown spots, “crêpe” skin and other eyelid aging skin changes. The new ActiveFX Laser Peel is a revolutionary new eyelid skin peeling technique that removes eyelid wrinkles, sun damage, and aged skin and creates new fresh youthful looking skin on the eyelid. This new ActiveFX peel can be done at the same time as the blepharoplasty so that true eyelid rejuvenation is possible, removal of eye bags, puffy eyes, dark circles under the eyes, and removal of wrinkles and eyelid skin aging changes.

This is the modern approach to eyelid rejuvenation, Total Laser Eyelid Rejuvenation for removal of eye bags, puffy eyes, dark circles under the eyes, eye wrinkles, and sun damage, all with no change in eyelid shape, no hound dog eyes, no sad eyed look, no hollow eyes, all with the help of the laser and the newest most modern eyelid rejuvenation techniques, the laser and the ActiveFX.

To learn more, contact me or read Save Your Face or follow this link.

Dr. Seckel,

Boston, Massachusetts

Concord, Massachusetts

978-369-4499

The eyes are the “window to the soul” and our most frequently viewed facial feature and unfortunately the first feature to show the signs of facial aging. Usually by the 30’s we begin to see crow’s feet, wrinkles, eye bags, dark circles under the eyes, and the start of eyelid hoods or hooding of the eyes.

(Contact Dr Seckel)

Traditional plastic surgery called the blepharoplasty can reverse many of these eyelid aging changes however newer methods using laser blepharoplasty and other laser eyelid rejuvenation techniques are vastly improved methods for eyelid rejuvenation. Newer, non-surgical eyelid rejuvenation techniques such as Botox and non-surgical eyelid skin tightening techniques such as the Aluma radiofrequency skin tightening device can improve and help prevent eyelid aging changes such as eye hooding, wrinkles, eye bags, and dark circles under the eyes.

The laser eye lift, which I call the “modern blepharoplasty”, combines new laser and non-surgical skin rejuvenation technology to produce dramatic eyelid rejuvenation without many of the drawbacks of traditional blepharoplasty.

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The laser eye lift combines the advantages of nearly bloodless laser incisional methods with non-surgical skin tightening and skin peeling methods for removal of wrinkles and tightening and freshening of the eyelid skin. For the first time we can achieve total eyelid rejuvenation, not just removal of eye bags and hooding of the eyes, but smooth young looking eyelid skin with fewer wrinkles and less sun damage and aging changes and removal of dark circles under the eyes.

In addition by using the laser to make a tiny incision on the inside of the lower eyelid (the transconjunctival blepharoplasty) we can avoid a visible scar on the outside of the lower eyelid. The transconjunctival blepharoplasty technique also avoids any change to the beautiful lower eyelid shape, a common and troublesome complication of traditional scalpel blepharoplasty with an external eyelid incision. In addition, with the transconjunctival blepharoplasty it is possible to release the arcus marginalis and thus truly remove dark circles under the eyes.

Advantages of the laser eyelid rejuvenation are:

1. Faster Surgery
2. Less bleeding
3. Less Bruising
4. Quicker Recovery
5. No visible scar on lower eyelid
6. No change in lower eyelid shape
7. Removal of Puffy Eyes, Eye bags, and Dark Circles Under Eyes
8. Freshening of Lower Eyelid Skin with Skin Tightening and Wrinkle Removal

The laser eyelift consists of 4 steps:

1. Laser upper blepharoplasty for removal of hooding of the upper eyelid
2. Transconjunctival lower blepharoplasty with arcus marginalis release and repositioning or grafting of fat to remove the dark circles and bags under the eyes
3. Laser tightening of the lower eyelid and a procedure called canthoplasty to tighten the lower eyelid and remove eye bags
4. ActiveFX Laser eyelid skin peel to remove wrinkles, sun damage , and tighten lower eyelid skin

The combination of these 4 steps provides truly total eyelid rejuvenation for the first time, something which the traditional scalpel blepharoplasty just cannot achieve. Furthermore with the advantages of less bleeding and bruising, recovery time is usually shorter than with traditional scalpel blepharoplasty.

During step 1of the laser blepharoplasty, the laser is used to remove the loose upper eyelid skin which is creating the eye hoods. After the loose skin is removed access is gained to the canthal ligament, which supports the lower eyelid, through the upper eyelid incision, so that the lower eyelid may be tightened in step 3 to restore the shape of the lax lower eyelid.

Step2, the transconjunctival laser blepharoplasty removes bags under eyes, puffy eyee, and dark circles under eyes. The conjunctiva is the pink portion of the inner lower eyelid, thus when the laser incision is made on the inner side of the lower eyelid it is called a transconjunctival incision. This approach avoids a visible scar on the outside of the lower eyelid. In addition, the supporting skin and muscle of the lower eyelid is not violated and thus the beautiful shape of the eyelid is not changed. One major drawback of traditional scalpel blepharoplasty is weakening of the lower eyelid and a downward turn of the eyelid referred to as an ectropion, also called the sad eyed look or hound dog eyes. The transconjunctival blepharoplasty avoids this complication.

During step 2 the eyelid fat which is causing the eye bag in either removed or repositioned so that it no longer causes the puffy eye bulge or eye bag. In addition, the arcus marginalis, a condensation of eyelid tissue which tethers the lower eyelid skin and causes the dark circle under the eye, is released allowing the dark circle to ‘open up”. In addition fat is placed beneath the dark circle to plump the dark circle. The combination of fat repositioning and arcus marginalis release remove the dark circles under eyes.

Step 3. During step 3 the laser is used to tighten the lower eyelid skin by shrinking the lower eyelid tissues through the transconjunctival incision. In addition, the canthal ligament, which supports the lower eyelid, is tightened with a suture placed through the upper lid incision, a procedure called a canthopexy. These two procedures tighten the lower eyelid and also provide a small amount of upper cheek lift.

Step 4. Step 4 involves refreshing, smoothing, and tightening of the lower eyelid skin using the ActiveFX laser eyelid peel. This new high tech procedure allows for rejuvenation of the skin surface of the lower eyelid and thus total eyelid rejuvenation. In the past with traditional laser blepharoplasty, hoods and bags were removed but the eyelid skin remained wrinkled and old looking. With today’s new laser blepharoplasty and eyelid rejuvenation techniques a truly fresh and rejuvenated eyelid appearance is possible. Botox is used to prevent the crow’s fet from coming back.

The laser eye lift is the modern blepharoplasty approach which provides total eyelid rejuvenation. For further information read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

978-369-4499