We interviewed Dr. Sandra Planella, a specialist in the Orbital and Oculoplastics Department
—Why is ageing so noticeable in the periocular area?
The skin on the contour of the eyes is the thinnest on our body. As the years go by and the first signs of ageing start to show, our ability to produce collagen and elastin diminishes, the skin starts to lose firmness and the structure surrounding our eyes loses its volume and position. In addition, every person blinks an average of 10,000 times per day. Due to this continuous movement, the muscles get weaker and the fat moves away from the socket causing bags under the eyes. Add these changes to external factors such as the sun, a lack of rest, stress and smoking, and you have the reasons why the eyes appear smaller and look permanently tired or sad.
—What do patients ask for in this regard? What are the most common aesthetic concerns?
Our face and, specifically, our gaze are our calling card and a key determiner in how old we look. That’s why it is increasingly common for both men and women to take an interest in the options for rejuvenating our appearance.
The majority of patients who come to our centre enquire about a blepharoplasty (eyelid surgery) and are seeking to eliminate the fatty bags that have appeared with the passing of time and the excess skin around the eyelids, with the aim of making the face look younger and eliminating the signs of ageing, tiredness and stress. We also see patients who present with bags under their lower eyelids (which have a significant hereditary component, but they can also be caused by thinning skin and diminished fat on the cheeks), who have prominent fatty bags or who are seeking solutions to improve the pigmentation, sinking and texture in that area.
—What are the treatment options to prevent the ageing of the skin around the eyes?
Facial ageing does not stop, but current treatments help us to maintain better quality skin for a much longer time.
The first thing we recommend you do is to control the factors that accelerate ageing. We can use basic measures to help keep our skin looking healthy: use UV protection (sunglasses, sun cream, mindful exposure to UV rays), drink lots of water every day, follow a varied and balanced diet, get the required hours of sleep to recover from the day's activities, do sport regularly and follow a healthy lifestyle: avoid smoking and don’t drink too much alcohol.
Using cosmetic products will help us to improve the skin's texture and make it more hydrated. Complementary products such as anti-oxidants or transformers, like retinol, will do the work to make our skin more radiant for longer.
To improve wrinkles like crow’s feet, frowning and on the forehead, we have the famous botox. This treatment alleviates wrinkles without losing your expression, in one single session. Skin peels and laser treatments are allies that can rejuvenate the skin around the eye contour.
And, finally, in patients with droopy eyebrows, droopy upper eyelids, excess skin or prominent fatty bags, we resort to surgery, most often combined in a single operation, allowing us to improve the patient’s appearance and facial expression without losing their personal identity.
Ophthalmologists specialising in oculoplastic surgery cover the complex anatomy of the periocular region, they work on it every day and can help patients to reverse the signs of ageing in this area without compromising our eye health
—Do you provide creams? Or just surgical treatment?
As oculoplastic surgeons, in addition to the anatomy of the eyelids and the periocular region, we must know all about the structure of the skin, how it works and how it ages. Therefore, we individualise patient treatment based on the type of skin, the characteristics of each bag under the eye, and on many occasions we provide suitable dermocosmetic products for the periocular. And if the type of under eye bag indicates it, we also inject a filler product, hyaluronic acid, and thus we improve the contour and sinking of the eye bag, softening the eye area.
—Why is it important to place yourself in the hands of an eye doctor when it comes to caring for this area, even though concerns are solely aesthetic?
Treatments to rejuvenate the eye area require the skills of an expert, as it is a very delicate area, close to the eyeball.
More than any other professional, ophthalmologists specialising in oculoplastic surgery cover the complex anatomy of the periocular region, they work on it every day and can help patients to reverse the signs of ageing in this area without compromising our eye health.
—How to choose from so many options? What is the patient consultation like? What does the choice of treatment depend on?
The eyelids are highly specialised structures and have a very complex anatomy. Therefore, the patient receives a very detailed consultation. A good diagnosis and treatment plan is a highly important element in achieving a satisfactory result.
Both non-surgical and surgical eyelid surgery or a blepharoplasty must be personalised because there are different techniques and the most suitable one must be chosen for each patient.
—What are the results like?
The post-operative period after a blepharoplasty is painless and the large majority of patients do not need any painkillers. However, all patients could have greater or lesser swelling during the first week. We should highlight the fact that the majority of patients do not have any problem getting back to their social activities and working life a week after the operation. The results of a blepharoplasty are long-lasting and conducting surgery on the same patient for a second time is uncommon.