Eyelid rejuvenation: which method to choose?

How can you tell that an eyelid is looking younger?

Structures in constant use

Their purpose is to protect the eye, and over time the eyelids undergo the ageing process.

Three specific features help to speed it up:

• the skin of the eyelids is particularly thin (about 0.5 mm, five times thinner than skin elsewhere) and therefore more fragile;
• these unprotected structures are highly exposed to external aggression, such as UV rays;
• finally, they are heavily in demand, since we blink about every 5 to 7 seconds. Even smiling affects our eyelids.

As a result, all the skin and muscle tissue undergoes accelerated ageing, sometimes out of step with other areas of the face. The ageing of the gaze then becomes more pronounced.

Sagging skin

The main clinical sign is sagging skin, with a loss of tone and elasticity, and drooping eyelids.

The loss of the underlying fatty tissue, particularly in the upper eyelids, produces the same effect by letting the skin tissue sag.

In the case of the upper eyelid, this affects the opening of the eye and gives a tired look: it is like a bag emptying, combined with excess skin that hangs.

For the lower eyelid, this slackening of the skin can be accompanied by the formation of underlying bags, giving a sad, sometimes puffy appearance. It is accentuated as the eye rim deepens.

Gradually, the movement of the eyelid is affected: a palpebral ptosis appears, deeply altering the physiognomy of the eyes and of the face.

What impact does a drooping eyelid have on the face?

Aesthetic impact

Any slackening of the eyelid tissue affects the gaze, giving the patient a sad, listless, tired and lifeless look, sometimes described as at a beaten-dog look…

It is often said that the eyes are the mirror of the soul, but here our eyelids betray us: they no longer reflect our true personality. However cheerful or lively we are, they project the image of someone sad and weary.

Functional impact

The eyelids play an active part in protecting the eye. Repeated blinking spreads the tear film and protects the eye from micro-aggressions (dust, fine particles, pollen and so on).

A lack of eyelid tension therefore reduces this protective function, favouring dry eye or irritable eye syndrome.

In more advanced cases, a marked palpebral ptosis impairs the visual field and reduces the opening of the gaze.

Comprehensive care: analysing every angle

A former head of ophthalmology specialising in oculoplastic microsurgery, Dr Hayot analyses the ageing of the eyelids as part of a comprehensive approach to the gaze. The gaze is truly the expression of a personality, even the mirror of the soul. That is why Dr Hayot’s philosophy is simple: we must rejuvenate the gaze while respecting it, because it is an essential part of our identity and our personality.

Other factors often accentuate the ageing of the eyelids, such as dark circles, wrinkles at the corner of the eye, and bags or hollows under the eyes. In such cases, treating the eyelids alone can leave the patient with an unsatisfactory aesthetic result, because she no longer “recognises” herself.

A rigorous analysis allows us to choose the most appropriate treatment, whether medical or microsurgical, while respecting the features of the face and of the gaze.

What are the different ways of rejuvenating the eyelids?

Aesthetic medicine to rejuvenate the eyelids: botulinum toxin injection

Aesthetic medicine of the eyelids answers very precise indications, such as the injection of botulinum toxin for certain expression lines, or for hypercontraction of the upper orbicularis muscle.
Aesthetic medicine to rejuvenate the eyelids: hyaluronic acid injection
Except in darker phototypes, injecting hyaluronic acid as a filler for hollow dark circles is clearly not recommended: it risks inducing bluish reflections through the Tyndall effect, making the final result disappointing.

In reality, the true solution for the eyelids is most often surgical: blepharoplasty.
Surgery to rejuvenate the eyelids: upper blepharoplasty

Eyelid rejuvenation surgery: upper blepharoplasty

Upper eyelid sagging can have two main causes, which call for completely different treatments: either simple slackening of the skin, or loss of the underlying fatty tissue that lets the tissues sag, or a combination of the two.

Excess and sagging skin

Performed under local or general anaesthesia, the upper blepharoplasty is carried out under an operating microscope, with a CO² laser scalpel. This high-precision procedure allows us to follow the contour of the eye perfectly and to resect the excess skin with millimetre precision.

About three months later, the scar is no longer visible.

Melting fat and sagging skin

Performed on all 4 eyelids, addition blepharoplasty consists in adding the patient’s own fat to recreate volume.

A CO² laser scalpel allows high-precision work, with very little bleeding.

The fat is always purified(lipofilling), or even processed to extract the best of it in the form of stem cells and growth factors(nano-lipofilling).

Eyelid rejuvenation surgery: lower blepharoplasty

For the lower eyelids, various lower blepharoplasty techniques are available, depending on the defect to be corrected.

Pocket removal

Internal transconjunctival pocket removal limits the risks of a traditional blepharoplasty, namely removing too much skin or too much fat.

Filling hollow dark circles

As hyaluronic acid fillers are not recommended, lipofilling is the only high-quality solution. It can also be used to treat the tear trough, should it be very deep.

Treatment of dark circles

Still little used in France, nano-lipofilling is probably the best solution for treating dark circles by eliminating transparency.

Palpebral fold: pinch blepharoplasty

For moderate excess skin (folds, wrinkles, crinkled eyelids), pinch blepharoplasty simply pinches the fold of skin to trim it, without detaching the tissues. It is a quick, minimally invasive procedure, performed alone or in combination with other eyelid procedures, to restore a lively gaze.

Regaining a youthful gaze requires a comprehensive approach. Thanks to his training in microsurgery, Dr Hayot offers exactly that: only a precise diagnosis makes it possible to choose the best blepharoplasty technique for a rejuvenated, lively and sparkling face. Rejuvenated eyes should never betray the original gaze.