Eyelid Surgery vs. Non-Surgical Options: Fillers, Lasers, and Surgery
With advanced facial rejuvenation options available now more than ever, patients looking to gain a brighter and more rested look in the upper face have a spectrum of cutting-edge treatments to choose from. There are many improvements that can be made to the upper and lower eyelid contours, which can be addressed through both non-surgical and surgical techniques depending on the specific concern. In this blog, double board-certified and fellowship-trained Newport Beach facial plastic surgeon Ali Sepehr, MD breaks down the most common aesthetic treatments to refresh the eyes and the longevity/effectiveness of each approach. He also sheds light on how the delicate tissues of the eyes age over time, and compares the benefits of surgical versus non-surgical interventions.
Causes of Eyelid Aging
Eyelid aging is influenced by a combination of internal and external factors that gradually impact the skin, muscles, fat pads, and supportive structures around the eyes. One of the primary causes is the natural decline of collagen and elastin production, which weakens the firmness and elasticity of the skin over time. Sun exposure exacerbates these changes by accelerating the breakdown of collagen and contributing to pigmentation issues and skin texture irregularities.
Genetics can also play a significant role in determining the onset and severity of eyelid aging, with some individuals predisposed to early drooping or prominent under-eye bulges. Lifestyle factors such as chronic stress, poor sleep, smoking, and repeated facial expressions, as well as habits like rubbing the eyes or sleeping on one’s face, can further contribute to your aesthetic concerns. One example is lower eyelid puffiness running in families, which refers to the fat pads around the eyes expanding and protruding due to weakening connective tissue. When these factors cause the eyelids to sag, bulge, wrinkle, or hollow, it’s not uncommon for men and women to look for ways to refresh their appearance.
Signs of Aging in the Eyelids
Through a combination of genetic predisposition, sun exposure, collagen loss, and changes to the natural anatomy, common concerns that develop in the eye region include:
- Sagging upper eyelid skin
- Puffy under-eye bags
- Dark circles
- Hollowing or volume loss
- Fine lines and skin crepiness
- A perpetually tired or aged appearance
All of these factors contribute to a perpetually tired or aged appearance. These factors can not only make you look older, but patients also frequently report they don’t feel like themselves anymore. Fortunately, Dr. Sepehr offers a complete suite of aesthetic options to help you age more gracefully and restore a brighter, more vibrant look in the eyes without sacrificing the natural character of your face.
Eyelid Lift
For those who do not mind a surgical procedure, upper and lower blepharoplasty offer the most comprehensive and lasting correction. Eyelid surgery, or an eyelid lift, removes excess skin, tightens lax muscles, and repositions or removes fat to restore a smooth, youthful contour. Blepharoplasty is ideal for issues that non-surgical options cannot fully correct, such as:
- Significant upper eyelid sagging
- Obstructed vision caused by droopy lids
- Prominent under-eye bags due to fat herniation
- Loose, excess, or crepey skin
- Bulging fat pockets
Since blepharoplasty addresses the underlying structures rather than simply treating surface-level concerns, the procedure provides long-lasting results and yields some of the most meaningful improvements in the appearance of the eyes. While surgery does involve downtime and a higher upfront cost, the outcome is typically more predictable and restorative than non-surgical options.
Dermal Fillers
For those who prefer a non-surgical approach or who have early signs of aging, dermal fillers can offer a subtle yet meaningful enhancement. Fillers like JUVÉDERM® or Restylane Eyelight® are commonly used to treat:
- Under-eye hollows
- Mild to moderate volume loss
- Dark circles caused by shadowing
- Transitional areas between the lower eyelid and upper cheek
Dermal fillers can be strategically placed to restore volume beneath the eyes, commonly in the tear trough area, thereby smoothing hollows and softening dark shadows. However, fillers cannot remove excess skin or correct bulging under-eye fat. While the results are temporary, with the proper technique, they can last several years.
Laser Treatments
Laser treatments provide another solution for rejuvenation, especially for patients whose primary concerns involve fine lines, wrinkles, skin crepiness, or uneven pigmentation. Some lasers are considered non-surgical and have little to no downtime and temporary results. Other lasers are considered to fall within the surgical category, as they have similar downtimes to surgery and similarly offer long-lasting results. CO2 laser skin resurfacing works by stimulating collagen production, firming and tightening the skin, and improving texture. Treatments can vary in intensity, from light resurfacing with minimal downtime to deeper laser therapy requiring one to two weeks of healing. Concerns commonly treated include:
- Fine lines and wrinkles
- Skin crepiness
- Pigmentation issues
- Sun damage
- Mild skin laxity
While lasers can significantly enhance skin quality, they do not correct structural issues such as fat herniation or large under-eye bags. Results are effective but do not stop the aging process, and maintenance treatments may be necessary to preserve improvements.
Ultimately, the best approach for you depends on your anatomy, goals, tolerance for downtime, and expectations for the lifespan of the final results. Whether you choose non-surgical treatments, surgical procedures, or a combination of both, the goal is to restore the natural brightness and youthfulness of the eye area. Consulting with a qualified facial plastic surgeon can help you determine the most effective plan for achieving a refreshed, rested appearance specifically tailored to your needs. Contact OC Facial Plastic Surgery today for more information or to schedule a consultation.
