Are the eyes really the windows to the soul?  They most certainly reveal your emotions, state of mind, and quite possibly even your overall health.  Ask yourself:  “What is the first thing I notice when looking at someone?”  Overwhelmingly, when we meet or approach someone, our eyes are drawn to their eyes.  This silent first impression tells us a lot about someone even before speaking to them.

In today’s society, stress, long workdays, and little sleep often impact someone’s appearance.  These changes can be permanent even when the stress has long since passed. There is a disconnection with that person’s inner vibrancy and healthy spirit compared to the look they wish to present to the world.  However, this does not have to be the case. Many technological advances are available to help you restore that youthful, refreshed appearance.

What made my eyes look so tired?

In general, as we age the eyelids go through changes.  The upper eyelid skin begins to loosen and the eyebrows start drooping.  Some people even have the upper eyelid fall so much it interferes with their vision.  This heaviness may also be accentuated by small amounts of fat protruding from around the eye into the eyelid.

 The lower eyelids also elongate over time.  The skin laxity can fold over and create “bags” that are also filled with small amounts of fat.  Dark circles form in the skin under the weight of the eyelid giving the classic tired and stressed appearance.  In some patients, the upper cheek contributes to the aged eyelid appearance and makes the lower eyelids appear worse than they actually are.  It is important to not overlook this relationship when examining the eyelids.

How can I get that refreshed appearance back?

In some cases, laser treatments or skin peels may be all that is required.  These patients may have fine lines or dark circles without having excessive amounts of skin or fat.  There are many patients at this stage that simply desire to look less tired.  Using chemical peels or laser treatments, the skin can be firmed and tightened without surgery.  Office procedures such as these are less costly and require less downtime.                                                   

In other cases, surgery is the treatment of choice.  Dramatic and permanent improvements can be made in these patients using relatively simple and inexpensive procedures.  Some procedures require no incisions on the outside of the eyelid.  Others may involve removing fat or repositioning the fat to fill in the upper cheek.  If incisions are required, they are placed just below the eyelash line or in the upper eyelid crease in a manner which produces virtually no visible scar.  In any case, there are many variations in eyelid surgery.  It is important that your surgeon has detailed knowledge and understanding of the relationships between the eyelids, cheeks, forehead, and the rest of the face. 

Henry D Sandel IV, MD

As people age their skin can sustain damage from years of sun exposure.  It is almost impossible to avoid sun on your face or use sun block every time you step outside.  It is even more difficult for people who love the outdoors and thrive in the summer sun.  Over time this damage can lead to skin lesions, brown spots, loss of elasticity, and enhance the loss of tone around the eyes, cheeks, jawline, and neck.  These findings can be discouraging to active healthy people who sometimes do not look as healthy as they feel.

The more common diagnoses found in my office are benign skin lesions called seborrheic keratosis, actinic keratosis, lentigines (brown spots), and nevi (moles).  They appear mostly on sun-exposed areas of the face and neck and can be a direct result of photodamage sustained earlier in life.  Although some lesions require biopsy to rule out cancer, most lesions can be determined to be benign just based on a patient’s history and skin examination.

Benign or noncancerous lesions are mostly found to have been present for a long period of time.  These lesions rarely undergo rapid growth or change in color or appearance.  Many of these lesions appear as flat brown spots, have a raised “stuck on” appearance, or have an even color with well-defined borders.  Some can even become quite large. 

The accumulation of these lesions on the face can have a negative effect on a person’s appearance.  Because of the location on the face, patients are hesitant to have them removed.  Most patients fear that removal will produce a scar or leave a white spot or depression in its place.  However, if properly removed to avoid damage to the surrounding skin, these lesions can be taken away completely with almost no evidence of scarring. 

Cancerous or precancerous lesions are generally those that have appeared suddenly, changed in appearance, or have undergone rapid growth.  They can be varied in appearance ranging from a small red area to a raised nodule, a discolored and irregular, possibly ulcerated lesion.  They can even present as an area that just doesn’t seem to ever really heal or is chronically flaking or peeling off.   These lesions should always be biopsied and sent for pathologic diagnosis.  If the area is found to be cancerous, it should be completely removed in a timely fashion and in such a way that produces a minimal scar and preserves the natural creases of the face.

To learn more about skin cancer, diagnosis, and treatment options visit the National Cancer Institutes website.  National Cancer Institute

There is not a set age that doctors recommend patients first attacking the aging process. Patients are unique; while emerging crow’s feet may bring one forty-something year old patient into the office, another 65-year-old patient may find beauty in her fine lines and instead seek to plump up her cheek area…

Read the entire article on the American Academy of Facial Plastic Surgeons website.

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