Droopy eyelids are a common concern, and until recently we had to live with it or undergo surgery to remove excess skin or raise the eyebrows.
Regenerative medicine or anti-aging medicine is the practice of treating the underlying cause of age-related health issues.
Traditional medicine would treat droopy eyelids by removing the effects of aging. The surgery is called blepharoplasty. The droopy skin is cut out.
Why do the lids get droopy as we age?
Did we grow more skin that needs to be surgically cut out?
There are two main things that occur over time that lead to droopy eyelids (in most cases):
1: Brow Muscles
The muscles of facial expression (what we call “mimetic muscles”) in the upper face are composed of two opposing forces.
There are muscles that convey anger, sadness, worry, skepticism, and frustration. All of these muscles lower the brow. Go ahead. Look in the mirror and give an angry face, the brow drops. There are 7 muscles that pull the brow down.
The muscle of your upper face that lifts the brow up conveys attention, attraction, and surprise. There is only one muscle of the face that raises the brow.
We have 7 muscles that lower the brow, one that lifts it. And we have gravity that wants to lower the brow.
Over time, gravity and 7 brow depressor muscles win, and the brow lowers.
Neurotoxin (such as Botox® or Xeomin®) can be used to weaken the muscles that lower the brow, and the brow will lift.
In this patient’s case, Xeomin® was used on all of the depressor muscles. The forehead was not treated so it can pull the brow up. Note the substantial lift. of the eyelids. After 1-3 cycles of lifting (a few months), there was some anti-aging effect on the muscles, so then we went ahead and further softened the forehead. with small doses of Botox®.
2: The skin loses its elasticity and thickness as we age due to years of exposure to the environment.
To combat this, the traditional method is to layer on concealing makeup, but can we apply anti-aging medicine to reverse the course of skin deterioration?
Absolutely. Topical skincare can help the skin restore collagen (thickness) and elastin (elasticity). Laser treatments can cause a controlled injury to the skin so it self repairs and restores.
Before and 2 months after Fraxel® laser resurfacing.
It is a process, but if we start thinking in terms of restoration, anti aging, or regeneration, we can consider the causes of effects of aging and target therapy to address the mechanism of aging.
The three can be combined. Skin care, neurotoxins, and laser treatments.
This is a 12-month progression. January 2021 thru January 2022. The lighting, makeup, and exposures may not be identical, but you can see the first phase was to weaken the angry expressive muscles (with Xeomin® in this case) that pull the brow down. This gives a stable and attractive brow lift. Much more natural-looking than a surgical brow lift. The last photo is after the brow has been stabilized and lifted for about a year, there is some “permanence” to the temporary effect of the neurotoxin (Xeomin® or Botox®) due to the muscles being relaxed for a year, they have atrophied or reverted to a more youthful state.
Once the muscles were restored, the skin was treated with SmoothEye™ which is an Erbium (Fotona Lasers) to reverse the laxity and thickness of the skin.
If you are concerned about droopy eyes, so are we. Surgery is still an option (and we offer it at Allure) but first, we think about reversing the cause and putting you on track to look and feel better with less risk.
Thank you,
– C Mok
