The area around your eyes, perhaps more than any other part of your face, can make you look either rested or fatigued, content or angry, youthful, or prematurely aged. Cosmetic eye services can significantly improve the appearance of puffy or baggy eyelids, fine lines, and wrinkles. The results of these aesthetic procedures can last months or years, depending on the type of treatment. 

Yale Medicine's ophthalmic plastic and reconstructive surgeons take a highly specialized approach to aesthetic eye procedures and surgery, giving you a younger, more refreshed look. “People tend to notice and focus on the eyes, which is why rejuvenation of the eyelids can make such a difference for patients from both an appearance and, in many cases, a vision standpoint,”says Mahsa Sohrab, MD, a fellowship-trained oculofacial plastic surgeon, and director of the Yale Medicine Oculoplastics & Orbit Program. 

Ophthalmic plastic and reconstructive surgeons pursue several years of additional training to blend their unique expertise in eye health with surgical skill. “Our ophthalmic training provides us with the skills to ensure the utmost safety of your eyes, while our aesthetic and functional training guides our selection of the proper procedures, both medical and surgical, to restore and enhance the function and appearance of the eyelids,” adds Dr. Sohrab.

Eyelid surgery, or blepharoplasty, is the most common cosmetic eye procedure performed at Yale Medicine. For the upper lid, the procedure involves making an incision in the natural crease of the eyelid, and then removing and reshaping the excess skin, muscle, and fat that develop with age and sun exposure.

Blepharoplasty can also be performed on the lower eyelid. As people age, the tissue that holds the fat in place can loosen and the fat can protrude, giving the appearance of bags under the eyes.

The most common surgical approach for lower blepharoplasty is from inside the eyelid, so there is no visible scar. As with upper blepharoplasty, the fat under the skin is reshaped and excess fat is removed. Frequently, at the same time, the skin in the area under the eyes will also be treated with either a laser or a chemical peel to improve its appearance. 

Yale Medicine specialists provide several other cosmetic eye procedures:

Skin resurfacing can be performed without blepharoplasty, either with a laser or chemical peel. Both types of treatment involve selective destruction of skin cells to encourage new collagen formation. Both treatments can be done in the office and may result in temporary redness of the eyelids and face, which gradually resolves over time. The amount of recovery varies, but it may take several weeks.

Brow lifts can surgically correct drooping eyebrows, which can make you appear to be angry or tired. There are several approaches, but a common strategy is to pair the procedure with the removal of excess upper eyelid skin, using a shared incision in the natural upper eyelid crease. Another method involves hiding the incision, which runs from the outside edge of one eyebrow to the outside edge of the other brow, within the hairline. During this form of brow lift, sutures are placed to elevate the tissue to restore the brow’s natural position. This procedure is done in the operating room under anesthesia, and recovery takes about one week.

A mid-face lift, or cheek lift can minimize the effects of gravity and aging, which sometimes cause the cheeks to sink downward, pulling the eyelids down along with them. A mid-face lift adds support and rejuvenates the area underneath the eyes. Incisions are made in a smile line in the corner of the eyelids, and then sutures are placed in such a way as to re-suspend the cheeks.

Eyelid crease revision can correct eyelid creases that are not symmetric; an operation recreates the crease in such a way that, as it heals, the new crease will be in the desired position.

Injections of Botox or similar products can treat wrinkles that appear when animating the face—smiling or frowning, for example. Where normal muscle contractions pull on the skin and create wrinkles, the prescription-grade toxin can, in small doses, temporarily block communication between nerves and muscles. When Botox is injected, the muscles do not receive the message to contract and wrinkles become less apparent. Botox and similar products last for about three months.

Injections of fillers can temporarily “plump up” an area of the face and diminish static wrinkles, which appear even when the face is not moving. The benefit of fillers can last between three months and one year, depending on the area injected.

“Each patient is different, and it’s not unusual for a doctor to perform a combination of these procedures,” Dr. Sohrab says. Completing several procedures at one time may expedite facial rejuvenation and reduce the total recovery time, she says.

It’s important that people who are considering cosmetic services have realistic expectations. “The focus is to keep people looking like a refreshed version of themselves,” says Dr. Sohrab. People who expect more dramatic results may not be good candidates for cosmetic services, she says.

Also, people considering skin resurfacing should be sure that their skin is properly evaluated by an oculoplastic surgeon or a dermatologist because the outcome of the procedure can be affected by skin type and color, previous sun exposure, and medication use. People who are not in good general health or who have conditions that increase their risks (for bleeding, infection, or scarring, for example) may not be good candidates for cosmetic procedures.

Generally, cosmetic services are not covered by medical insurance. But in some cases, if an eyelid’s drooping is severe and affecting vision, upper blepharoplasty may be covered. Simple tests done in the doctor’s office can determine whether the condition warrants insurance coverage.

Cosmetic eye services at Yale Medicine are performed by ophthalmologists who have specialized and extensive education, training, and experience in these procedures. Our oculoplastic specialists have unique knowledge of the anatomy of the eye and surrounding area that benefits patients seeking treatment to improve their appearance.