Eyelid Rejuvenation Treatments For Under-Eye Bags, Droopy Upper Eyelids, And Dark Circles

Of all the parts of the face, the area around the eyes is usually the first to betray a person's age. Called the periorbital area, signs of aging like crow's feet, loose skin, droopy upper lids, and under-eye bags can manifest in this part of the face. Fortunately there are many eyelid rejuvenation techniques that address each and all of these concerns. Below I've outlined some common age-related issues that occur around the eyes, and possible corrective treatments.

For hanging upper eyelids, try a lift (called an upper blepharoplasty).

A common sign of aging is the appearance of hooding or excess overhanging skin on the lids. Sometimes this even partially obstructs part of your vision. A popular solution to this issue is an upper eyelid lift, which we call an upper blepharoplasty. This surgical procedure removes excess skin, muscle, and fat from the upper eyelids. It can also give an extra lift to the eyebrows.

What's the downtime?

Upper eyelid lifts produce an immediate improvement in the contour of the upper lids and overall appearance of the eyes. As with any surgical procedure, you might experience swelling and bruising afterwards. This will gradually resolve. Sutures will need to be removed within the first week after surgery. You should avoid strenuous physical activities and vigorous exercise for two weeks.

Who is the ideal candidate?

Ideal candidates for upper blepharoplasty are people who have excess skin or hooding of the upper eyelids. If you have ophthalmologic issues such as dry eye or eyelid ptosis, you may also benefit from the surgery. (You will most likely require additional eye medications or surgical ptosis repair to ensure best results.)

How much does it cost?

Upper blepharoplasty is best performed by a board-certified plastic surgeon under monitored sedation. Total costs including fees for the surgeon, facility, and anesthesiologist often range from $7,000-$10,000.

Tear trough prominence can be corrected with fillers, microneedling, or laser resurfacing.

Tear trough prominence describes a depression at the bottom edge of the lower eyelid. This appears as dark lines or circles at the junction of your lid and cheek skin. Treatment may include a combination of fillers (such as JUVÉDERM) or fat injections to camouflage the bony edge. You can also opt for skin rejuvenation procedures such as microneedling (with or without PRP), chemical peels, or laser resurfacing.

What's the downtime?

Downtime for tear trough correction depends on your anatomy, the type of treatment you choose, the depth of the penetration, and strength of the products used. It may range from no downtime if fillers alone are used, to days for microneedling with PRP, to weeks or months for laser resurfacing.

Who is the ideal candidate?

If you have noticeable prominence or darkening in the area, are in good health, and have generally good skin tone and elasticity, you're a good candidate.

How much does it cost?

Cost will vary depending on the treatment performed. Fillers or chemical peels might be several hundreds of dollars, while laser procedures will set you back a few thousand.

A lower eyelid lift can treat under-eye bags.

This usually occurs when the fat inside the lower eyelids bulge and the skin in the area thins and loosens. These bags are best treated with a lower eyelid lift called transconjunctival blepharoplasty. Done inside the lower eyelid, the procedure leaves no visible scar.

What's the downtime?

Surgery to correct lower eyelid bags may cause some swelling and bruising, which usually improve significantly after the first few days. You will be restricted from exercise and excessive physical activity for two weeks post-op.

Who is the ideal candidate?

Some people develop lower eyelid bags in their teens and 20s, as an inherited family trait. For others, the appearance of under-eye bags becomes more noticeable with time. Transconjunctival surgery that removes or repositions the visible fat could be an effective solution whether your undereye bags are a result of genetics or aging. Patients should be examined prior to surgery to evaluate the position, strength, and tone of the lid, and to determine if additional eyelid procedures are needed.

How much does it cost?

As with upper blepharoplasty, costs involve the fees for the plastic surgeon, facility, and anesthesiologist. The total cost usually ranges from $8,000-$12,000.

Excess skin on your lower eyelid can be treated with microneedling, PRP, or skin pinch surgery.

Aging and sun exposure can produce loose, thin, crepey skin and excess wrinkling of lower eyelid skin. Treatment options include skin tightening with microneedling or PRP. Surgical options include excision of excess skin with skin pinch surgery or a lower eyelid lift. Depending on your anatomy and the results you hope to achieve, an upper eyelid lift may be performed concurrently with a lower eyelid lift. This can be done using either a transconjunctival (inside the lid) or skin incision approach.

What's the downtime?

With microneedling or PRP, you can expect minimal downtime. A lower eyelid lift will require two weeks of refraining from excessive physical activity, and skin pinch surgery might result in bruising or swelling for a few days.

Who is the ideal candidate?

If the excess skin beneath your eyes is too delicate for chemical peels or procedures involving lasers, one of these treatment options might be right for you.

How much does it cost?

Skin pinch surgery on its own will cost around $5,000 on average. A comprehensive examination by and discussion with your surgeon are essential before deciding which procedure or combination of treatments is best for you. Always choose an experienced board-certified plastic surgeon who specializes in eyelid rejuvenation options.  

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