Fashion

We grilled a top cosmetic eye doctor on treatments for everything, from puffiness to droopy lids



There’s no doubt that your eyes are the first thing people see when they look at you. But as of 2020, they’re now the only thing people see, with face masks having been made mandatory across the UK and many countries across the world.

So, it’s no surprise that more and more people are becoming increasing aware of the appearance of their eyes and the surrounding area, with aesthetic clinics and beauty salons experiencing a steep increase in demand for all eye related treatments. According to beauty treatment booking website Treatwell, eyebrow threading and waxing came back strongest with an increase of 794% vs. pre lockdown figures, and the popular LVL lash lift also coming back strong with an increase of 698%.

As well as the standard beauty maintenance treatments, more people than ever are contemplating more invasive procedures like dermal fillers, Botox and even surgical treatments to address their eye concerns. To get the low down on the safest and most effective treatment for every type of concern, we called upon Dr Maryam Zamani, leading Oculoplastic Surgeon and aesthetic doctor.

“With masks and video conferencing, a lot of attention has become focused on the eyes and looking well rested. I have people coming in complaining of droopy upper eyelid skin, dark circles and puffy lower lids.”

Here’s the best treatment for the most common types of eye concerns and complains…

PUFFY EYES
According to Dr Zamani, treatment of puffy eyes would heavily depend on the underlying cause. “Some patients present with puffy lower eyelids caused by weakness in the lymphatic drainage in the area,” she explains. “Often they complain of puffy lower eyelids in the morning that improve during the day. Sometimes oral medications can be used in conjunction with eye creams that help drain and detoxify the area. Diet and manual manipulation can help as well.”

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However, in some cases, puffiness is caused by fat prolapse in the lower eyelids. “Depending on the presentation sometimes lower eyelid blepharoplasty is needed to permanently debunk those fat pads,” says Dr Zamani. Blepharoplasty involves a short operation, of between one to three hours, where excess tissue is removed through a small incision.

“Others think that have puffy eyelids but they have actually lost volume in that area. For those patients, treatment with hyaluronic acid fillers can be used to add volume to the area and create a more even lower eyelid.”

CROW’S FEET
According to Dr Zamani, lines and wrinkles around the outer corners of the eyes are caused by the movement of the concentric obicularis oculi muscle. “This muscle can be weakened using botulinum toxin, otherwise known as Botox. A few injections in the area can help elevate the lateral eyebrow and can be used to soften those lines and wrinkles.”

In others, invasive procedures might not be needed. “A bit of skin hydration with hyaluronic acid can be used to improve skin quality and of course, good skin care is of utmost importance.”

DROOPY EYELIDS
“Upper eyelid blepharoplasty is the gold standard to remove excess skin and medial fat from the upper eyelids,” explains Dr Zamani. However, in younger patients that have only a small amount, she recommends a combination of injectables including dermal fillers and Botox, and sometimes a bit of ultherapy to help tighten the skin in that area.

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DARK CIRCLES
Dark circles are one of the most common complaints when it comes to eyes, as well as one of the most complex. Dr Zamani explains that there can be a number of potential causes, each of which requires its own treatment plan.

“Dark circles can be hereditary or the result of genetics,” she says. “For instance, patients of south East Asians can have hyper pigmented periorbital skin. This is difficult to treat and often require long term treatment with lightening creams and on occasion lasers. This is also true of other individuals who also suffer from
photo damage around the eye area.”

Another potential cause of dark under eye circles is prominent blue blood vessels (reticular vessels) that cause shadowing in the lower eyelid. “In these cases, I use something called a Long Pulsed Nd:YAG Laser to shrink the vessels, making them less visible through the skin periorbital skin.” This treatment requires anything between 1-4 sessions to have optimum effect.

There’s also the possibility that dark circles are caused by volume loss in the tear trough. “This demarcates where the eyelid ends and the cheek begins,” explains Dr Zamani. “Using a small amount of hyaluronic acid to add volume the area helps even out the area.”

“Sometimes there are environmental factors like seasonal allergies, sinusitis, smoking, and pollutants that can cause poor lymphatic drainage in the area creating dark circles,” she explains. In these cases, medication and smoking cessation can help.

Check out our in depth guide to getting rid of dark circles, as well as the best concealers for all skin types.

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