The area around the eyes is the first to show signs of aging, and as such it enables people to guess our age very easily. It is also an essential part of our face for transmitting emotions.
Signs that give us away
Lines between the eyebrows makes us look stern and angry, though they usually only appear unconsciously, when we are concentrating on a conversation. The loss of fat around the temple area, which is unavoidable when we age, makes our face look older and more tired. Hollow temples evoke an image of illness or malnutrition. This loss of fat also leads to a lack of support for the lateral part of the eyebrow. The eyebrow droops down and makes your face look tired, even if you are feeling on form. Excess skin might also sag down over the eyelid from the surrounding areas. The under-eye area and tear trough become hollow due to the loss of fat around the eye socket and the progressive bone resorption in this area. This loss of projection reveals the area’s small fatty deposits and gives an overall look of fatigue that is difficult to hide.
Shadow and light
In a young face, the area around the eye reflects light in a uniform way. There are no lines dividing the different aesthetic units: forehead, temple, cheekbone, eyelids. The loss of fat around these units leads to the appearance of areas of shadow and light, which are tell-tale signs of aging. The bones are more visible through the skin, making the face look senescent or malnourished, and in extreme cases we might even talk of a corpse-like face.
The inversed cone of youth
The aim of any medical or surgical work carried out on the eye area is three-fold: restore the inversed cone of youth; restore the facial tissues’ support network; and achieve a positive and natural-looking expression. A young face has more volume in its upper half than in its lower half, which is why we talk about an “inverted cone”. As we pass 40, this changes and the lower part of the face becomes dominant. The eye area becomes hollow and the volumes of the lower face increase. Jowls appear, the centre of gravity of the cheekbones and cheeks becomes lower, and the marionette lines deepen. As fat is lost from around the eye, the tissues lose their support, but this support can be restored through treatment. The aim is not to create volume for volume’s sake, but rather to reposition the aesthetic units to their original position by restoring the inverted cone of youth. Precise treatment of these areas will enable us to achieve a harmonious facial dynamic and a positive expression.
Volumes can be restored surgically using implants or, more often, by transferring autologous fat taken from the inner thigh. The advantage of lipostructure is its simplicity: there is no detachment and the areas to be treated can be targeted in a highly accurate way. The temple area, eyelids and cheekbones can all be treated this way. By adding a temporal lift, we can also gently reposition the tail of the eyebrow. The main drawback of this type of surgery is the average downtime of 10 to 12 days.
Nowadays, gentle neuromodulation (using Botox blended with new hyaluronic acids) often enables us to rejuvenate the eye region non-surgically in a clinic. Botox is used as much to restore the balance of the muscles as it is to erase unwanted wrinkles. By reducing the action of the muscles that draw the eyebrows downwards, we make the job of the muscles that lift the eyebrow easier. This enables us to open up the expression and erase those signs that make the patient look sad or tired. Hyaluronic acid corrects the lost volumes around the eye socket, but above all restores the support of the eyebrow and the middle third of the face (cheekbones, under eye area, cheeks and nasolabial folds) (Figure 2).
Nowadays, there are so many kinds of medical and surgical techniques available that we are able to adapt our treatments to each patient’s desires and rejuvenate the eye area in a natural-looking way.
About Dr Olivier CLAUDE
Plastic, Reconstructive and Cosmetic Surgeon, D.E.S.C. medical specialisation diploma, diploma from the French College of Plastic Reconstructive and Cosmetic Surgery. Assistant at Yaremchuk Plastic Surgery – Harvard, Boston, USA, Fellowship Plastic Surgery Laboratory – Harvard, Boston, USA.