Every day I see patients who want refreshed, less tired looking and more youthful eyes.  They all ask about how to do this surgically.   Clearly surgery is the mainstay to improving sagging and puffy eyelids.  However, non surgical treatments such as Botox and fillers (Restylane, Juvederm, etc.) can be a powerful alternative, especially in patients under the age of 45-50.

We tend to think of Botox as a wrinkle treatment because that is the way it is marketed.  In reality it is a muscle weakening agent (which in turns secondarily reduced wrinkles).  The forehead, eyebrows and eyelids are in a dynamic state of equilibrium consisting of muscles that elevate or depress these structures.  By “weakening” an elevating or depressing muscle (depending on needs) I can change the position of the brow, the fullness, heaviness and puffiness of an eyelid, and improve the contour of the lids.  This is a very important concept.  Let me repeat.  I can significantly improve eyebrow/eyelid position and appearance without surgery (with Botox).  This is an extremely important piece of information for those not yet ready for surgery.

Fillers are equally as important as Botox in non-surgical eyebrow/eyelid rejuvenation.  Restylane and Juvederm, can be injected around the eyes to add volume and support to the eyebrows and eyelids.  This supports acts (like Botox) to help lift and contour these structures.  While fillers work in a different way than Botox the two products acts together very well to improve the aesthetics of the eyelids.