Rejuvenating the Eye Area

Find out which eye treatments can help to improve signs of ageing for men

Rejuvenating THE EYE AREA

Mr Daniel Ezra, oculoplastic surgeon, NEO Health Clinic, London IG: @eyesbyezra Miss Jennifer Doyle, ophthalmologist, Oxford Aesthetics, Bicester, Glasgow and London IG: @oxford.aesthetics

They say the eyes are the window to the soul. But sometimes, the appearance of the eyes and surrounding areas can belie what’s behind them, giving a false impression of the individual. According to Mr Daniel Ezra, these types of misconceptions can drive male patients to undergo aesthetic treatments to the eye area. He explains, “People can make assumptions about how others look. If you have large bags under the eyes, you might look like you’ve been up all night and not keeping up with your work, and people who have very low eyebrows and frown lines can look angry and unapproachable,” he says. “So, we’re often influenced by certain emotional and behavioural assumptions others make about us, based on how we look.” This is a significant motivating factor for men, whom Dr Ezra says comprise as many as 30% of his clientele seeking eye rejuvenation treatment. Aesthetic procedures in general are 10 times more common among women than men. Yet demand from the male population has increased by up to 50% in the last few years, not least because of the so-called ‘Zoom boom’. People see a somewhat distorted picture of themselves on a video screen, leading many to zero in on their perceived imperfections. And men are arguably more susceptible, being less used to examining their mirror image in such forensic detail as women.

Age-related changes around the eyes

Alongside tweaks to the jawline and hair loss treatment, the eye area – known by medics as the periocular/periorbital region – is among the top three areas of focus for men. And it’s not surprising, since the eyes bear many of the hallmarks of facial ageing – hooded eyelids, crow’s feet, frown lines, bags, and dark circles, for instance. As we get older, collagen production declines and the skin loses elasticity, resulting in lines, wrinkles and loose skin. This tends to be more marked around the eyes, according to Mr Ezra, where fluid builds up due to poor lymphatic drainage in the tear trough area, and where excess skin can create a sagging effect around the eyelids. “The eye socket itself is also full of fat,” Mr Ezra explains. “With age, the membranes holding that fat backwards weaken, and the fat begins to bulge forwards causing under-eye bags.” The skin around the eye is around four times thinner than elsewhere, so it’s often the first area to show age-related changes, giving that tired, sullen appearance that no amount of sleep will fix.

Types of treatment

Whatever the concern, there are several tools of the trade that can help combat them and rejuvenate the male eye. The more invasive options include blepharoplasty and surgical brow lifts, explains Miss Jennifer Doyle, in which fat or excess skin is ablated from the eyelids and the brow area respectively. “Surgery can take decades off the right candidate and may be suitable for patients seeking dramatic results,” she says. But these procedures entail considerable downtime and carry the tell-tale signs of cosmetic surgery, like stitches and prolonged swelling and bruising. For men who want subtler rejuvenation, to simply look more refreshed, the payoff isn’t worth the price. With fewer men choosing to go under the knife, non-surgical alternatives are rising in popularity and, as Mr Ezra says, it’s prudent to consider them as a first step before going down the surgery route.

Skincare As a first line of defence and to proactively halt periorbital ageing, many practitioners recommend topical skincare solutions containing retinol. A derivative of vitamin A, retinol slows collagen degradation, plumping saggy skin and smoothing wrinkles. According to Miss Doyle, patients often see positive results. “Getting someone on a really good retinol designed for the periorbital area, such as the AlumierMD Retinol Eye Gel, is an excellent place to start,” she explains, “because they should get improvement from the retinol’s thickening effect in the skin.” Thickening the skin not only irons out lines and wrinkles, but also strengthens the surrounding tissue’s structure, which helps to hold back accumulating fluid and periorbital fat, reducing bulging and minimising the appearance of bags. With any retinol product, the key is patience – results won’t magically appear overnight – and starting on a low concentration to avoid irritation. Miss Doyle says it can be increased incrementally as the skin adapts, with gradual improvements seen over a period of several months.

Injectables for the eye area Men wanting a quicker fix to reverse signs of ageing can turn to injectables. “Dermal fillers can be helpful for localised hollowing, particularly tear trough hollows, where you can get fantastic results in selected patients,”

Mr Ezra comments, adding that botulinum toxin (known by the common brand names Botox, Bocouture, Juvenus and Azzalure) can be helpful in smoothing out crow’s feet and frown lines. For the delicate under-eye area, practitioners use dermal fillers containing hyaluronic acid (HA). The naturally occurring ingredient supports collagen production and boosts hydration, and because it’s a clear gel, it’s easy to smooth, and gives a natural aesthetic to tear trough hollows while also tackling dark circles. Only a handful of dermal fillers are licenced for under-eye use in the UK, and the Teosyal Puresense Redensity 2 product by Teoxane is favoured by both Miss Doyle and Mr Ezra. Miss Doyle also uses Juvéderm Ultra by Allergan, while Mr Ezra adds Galderma’s new Restylane Eyelight to his product list – turn to p.25 to find out more about this product! It should be noted that injectable treatments aren’t suitable for everyone and those interested should seek a consultation with a registered medical professional.

Other options to rejuvenate the eye area If dermal fillers conjure an image of celebrities sporting the puffy ‘pillow face’ look, you’re not alone. Although the right practitioner will be able to achieve a natural look, men in particular sometimes shy away from injectables, associating them with a plump, rounded and more feminine facial aesthetic. The male bone structure may also rule out under-eye fillers. “A lot of men have what we call a negative vector, so instead of the cheeks projecting forward they’re more concave,” Miss Doyle explains. “Those men are quite difficult to treat with tear trough fillers because they don’t have support from the mid-face to hold up the area under the eye.” Don’t worry though, there are alternatives! Skin tightening treatments are often more suitable for these individuals, Miss Doyle adds, noting, “We offer a laser procedure called SkinTyte from Sciton, which uses infrared to heat the tissue to about 40-42 degrees and that stimulates collagen, so you get a nice tightening effect on the lax skin around the eyes.” Another option is platelet-rich plasma (PRP) therapy, in which plasma is extracted from the patient’s own blood and injected under the eyes. In high concentrations, plasma contains growth factors and that all-important collagen, so it regenerates skin cells and improves the skin’s quality. Crucially for male patients, it does so without ostensibly altering the features. Radiofrequency microneedling is also an option, which Miss Doyle says can give impressive results. “I use the Morpheus8 radiofrequency microneedling device, and combined with PRP, it can improve and subtly rejuvenate the eye area,” Miss Doyle adds.

Patient and treatment selection

When rejuvenating the eye area, choosing the most appropriate treatment options for each patient is key to achieving optimal results. That’s especially true for men, because the desired aesthetic is usually very different than for women, and therefore requires a different approach. For example, female patients typically want a higher, arched brow while men tend to prefer the more masculine shape of a flatter and lower brow – although everyone is different and the desired outcome depends on individual preference. “Women like to have a lot of their eyelids showing, but in a man it can sometimes look odd. It’s very important that your practitioner understands the male aesthetic,” says Mr Ezra. Treatments for hooded eyes or drooping brows should be aimed at eliminating excess skin without lifting the brow too high, revealing much of the upper eyelid and giving an overly feminised look. “It’s only surgery that will do the job,” he adds.

Likewise, Miss Doyle points out, a good skincare regime or a course of injectables can only achieve so much. “Those non-surgical options will improve and subtly rejuvenate the area, but they won’t remove large under-eye bags,” she explains, adding that in such cases, again, you’ll need to consider surgery. With men often wanting a less obvious result – cosmetic treatments are “still seen as quite a feminine thing to do” Miss Doyle comments – it’s important to manage expectations. “I always gauge what people want to achieve and what downtime they are willing to go through to get it,” she says. There, the patient’s age is a consideration. Older, retired men, according to Miss Doyle, are often more open to surgical options and the associated after effects (visible stitches, bruising etc) and recovery time. “But the younger cohort of men who are still working, in their 30s and 40s, don’t really want people to know,” she notes.

Top tips for eye rejuvenation

You’ll find someone offering aesthetic treatments on every high street, but for anyone thinking of eye rejuvenation the message is simple: choose your practitioner wisely. “Often the complications you see are because practitioners don’t understand how to match the right patient with the right treatment,” says Mr Ezra. “You need someone who is highly skilled in the eye area to advise on that.” Miss Doyle concurs, pointing out that with the delicate and unforgiving eye area it’s always best to err on the side of conservative caution, and consider non-surgical treatments first. “However, if you’re going for surgery, I recommend seeing an oculoplastic surgeon rather than a generalist as they are specialised in this area.”