Getting Over the Under Eye Area
Don’t you love it when someone utters “Wow, you look tired!”?!
I always want to respond with, “why don’t you just say ‘Wow, you look like sh&t!’.
Nine times out of ten, the commenter is referring to that sad, depressed little area under the eyes. With everyone suffering from the “Zoom Effect” and having to look at themselves on camera for a while now, more and more patients are coming to me asking what to do to improve the under eye area. So let’s talk about some of the many, many options and my recommended treatment path (generically of course because everyone has unique needs).
There are many schools of thought of how to treat the undereye area, and it really depends on what problem we are trying to solve. Following the path of least resistance, if you’ve been in my chair and we are talking about skin care (regardless of what you are having done). I wholeheartedly recommend PCA Ideal Eye Gel (click here to purchase) for use daily morning and night. I have a lot of tricks up my sleeve, but skin care is number one and that under eye area is so delicate and very thin- it needs a dedicated product. It is the only eye gel/cream that I have found in my experience to provide intense hydration to help with fine lines, improve texture, tighten, and help minimize dark circles with regular use. It is one of the very few that can be used on the upper lid as well. And the added bonus, it’s a great primer for makeup! So even as we discuss other interventions, adhering to a regular product regimen is priority number 1 and the best use of a few of your ‘beauty bucks’.
Now that we have that settled and you’ve fallen in love with the eye gel, let’s talk about the ways we can improve texture, reduce dark circles, and build upon volume. During your consultation, I will assess the under eye area, ask what bothers you and what you are seeing in the mirror (with and without makeup), then touch your face. We need to decipher from a few things:
- Is it hollowness from fat loss over the years/ weight loss/ exercising?
- Excessive eye rubbing over the years and skin is more lax?
- Genetics?
- Fat pad formation/herniation?
- Is this a consistent and always problem or just an occasional issue?
Once we determine the culprit we can discuss treatment options. With excessive skin or fat pad herniation, we need to assess surgical and non-surgical options (don’t worry, I have great referrals for you if needed, and don’t forget, I’m plastic surgery trained).. I am brutally honest and don’t want you to waste your time and money on repeated treatments if I know that surgical intervention is the best option for you to help you achieve your goals.
My preferred method of improving hollowness and dark circles is utilizing your own plasma under your eyes. This is called PRP/PRF/PRFM (Platelet-rich-plasma, fibrinogen, or matrix) treatment. This involves me drawing your blood, spinning it in a centrifuge, and extracting that rich golden PRF. This is then injected under the eye area with a needle and/or a cannula (a soft tip needle) to help your body to stimulate collagen and elastin production to enhance fine lines, wrinkles, and improve the tone and texture of the under eye area. Post procedure, you are puffy and appears that you’ve had a good cry, but nothing that big sunnies can’t hide. You do need to avoid the direct sun for the next 24 hours and commit to sunglasses. Results are best when this is done in a series of three treatments, with 4-6 weeks in between. This can be done in conjunction with microneedling and/or chemical peels to maximize each treatment. Microneedling forces a collagen response to build new collagen, strengthening the skin over time, while chemical peels force a skin turnover promptly which improves texture, tone, and skin strength while repairing the DNA of skin cells.
While PRP/PRF is my love child, I occasionally get the ask for straight under eye filler. While fillers will provide that instant gratification, the longevity is not there a lot of times, and the risk of an adverse reaction (migration, prolonged fluid retention, nodules, or vascular occlusion) is very high. That area is so thin and blood-rich that it is rarely in my protocol to inject filler only. I have seen many patients come in after having straight filler injected who now have complaints of lumps and bumps and want it dissolved. Don’t worry, this can be done, albeit an expensive challenge.
Now, depending on the severity of the volume deficit, your PRF can be mixed with a little filler to help with volume issues. Also, because this is as much of an art as science, we frequently discuss adding mid face volume support with fillers in combination with PRF to help maximize your non-surgical results. Again, everyone is different and why a thorough consult is provided and necessary!
If PRF sounds like your jam, I highly recommend checking out the VIP Experience (click for deets). This allows your PRF and your chemical peels to be cost controlled and cost effective, as well as providing a free skin treatment every three months!
