It’s the ultimate rude awakening: You get out of bed one morning, look in the mirror, and are confronted by dark circles under your eyes, maybe a bit of sagging along your lids. No problem, you think. All you need is a good night’s sleep. Then you remember, you did have a good night’s sleep. That tired look is actually your new normal. Until recently women faced with this situation had two options: surgery, or invest in an extensive wardrobe of sunglasses. But that was then. Now a combination of minimally invasive treatments can take the place of plastic surgery. “When it comes to the no-knife lift, it’s all about the three R’s,” says Adam Kolker, M.D., a New York plastic surgeon. “Relax, refill, resurface.”
RELAX MUSCLES
Botox may not be the new kid on the block, but it can still give your eyes a big lift, according to New York dermatologist Robert Anolik, M.D. “When you inject Botox into the tail of the eyebrow as well as between the brows, it stops the muscles from pulling downward,” he explains. It also decreases lines. Beware of too much Botox in the forehead, however. The muscle there is designed to lift the brow; freeze it, and it won’t be able to do its job. Results last for three to four months. (Cost: $300–$1,500, depending on the amount used.)
REFILL VOLUME
As we age, the skin under our eyes loses volume, causing hollowing and making fat pockets more pronounced. Kolker (like many other doctors) camouflages bags by using Juvéderm and Restylane off-label, pumping it along the orbital rim of the lower eyelid, which smooths out the area. (“It’s common practice among experienced injectors and well supported in peer-reviewed literature,” he says.) “Fillers can make you look as though you’ve slept 12 hours,” says Paul Jarrod Frank, M.D., a dermatologist in New York. “They also help build collagen, so dark circles are less visible.” Risks include allergic reaction and, though extremely rare, blindness, if a needle is injected into a blood vessel. (All the more reason to see only a board-certified derm or plastic surgeon for any of these procedures—they have a much stronger knowledge of anatomy.) There’s no downtime, and results last for about one year. (Cost: $500–$2,000, depending on how much filler is used.)
RESURFACE TEXTURE
Microneedling is being used to tighten upper and lower lids. After a numbing cream and eye shields are applied, a stamping pen with multiple thin needles penetrates the skin from one to two millimeters. “This stimulates collagen production, which tightens skin and improves tone, texture, and firmness. It also can reduce dark circles,” says Ariel Ostad, M.D., a New York dermatologic surgeon. The 30-minute procedure may cause swelling and bruising for up to a week, and three to five monthly treatments are recommended. Results last for two to three years. (Cost: $500–$1,500 per session.)
The procedure that comes closest to the full spectrum of results from an actual eye-lift is fractionated CO2 laser resurfacing using a fractionated ablative carbon dioxide laser. “It creates thousands of tiny wounds that spur skin to build new collagen and elastin as it repairs itself,” explains Dendy Engelman, M.D., a dermatologist in New York. The results: tightening, improved clarity, and reduced crepiness. “You’ll see superficial improvement in a week and increasing improvement over the next four to six months,” she says. After a numbing cream is applied, the treatment takes about 10 minutes (expect a mild burning sensation), followed by four to seven days of swelling, redness, and peeling. Results last for at least one year. (Cost: $1,200–$1,500.)
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