An Eye For Detail

An Eye For Detail

BY Dr Terrence Scamp

Sophisticated equipment can track the direction of gaze as one looks upon a human face. Recordings show that much of the time that we look at another’s face we are looking at their eyes.

This is not surprising in itself. As a species we have excelled by our communication skills, and much of that communication is done not with words but with expressions. Emotional changes often manifest as subtle alterations in facial expression and we are all very sensitive to these.

The eyes are also considered an object of great beauty so with their prominence and the attention they attract it is not surprising that requests for cosmetic surgery to the eyes are among the most common. It is also one of the more common surgical procedures in men, who are generally more shy when it comes to cosmetic surgery.

In the upper lids most commonly, people complain of heaviness. They will pinch the excess skin in their top lids and ask that this be gone. However, it may be that the heaviness there is a manifestation of disturbance in brow position more than eyelid skin. Or it can in some cases be a combination of both. So a decision has to be made between surgery to the upper eyelid and whether or not this needs to be combined with a keyhole brow lift. Both of these procedures are easily done as a day patient and recovery is relatively pain-free. However, any operation around the eyes results in bruising which varies in degree but commonly hangs around for seven to 10 days. And gender differences apply here too. The lower brow can make a man look strong and firm of purpose, but it may not suit the female. A nicely arched and elevated brow can highlight a lady’s eyes, but on a male it can all too easily look odd and overdone.

People also commonly complain of ‘bags’ – puffy pockets of fat that give them a sleepy or tired look. In the lower lid these can commonly be addressed through a scar less approach, while in the upper lid the scar is usually easily hidden deep in the lid crease.

In the 60s and 70s surgery to this region was relatively aggressive. Skin was pulled tight and fat pads reduced to a minimum. The down-side of this was commonly seen in the ageing film starlet, whose eye took on a hollow and gaunt look.

Appreciation of the ageing signs around the eyes has taken on a lot more sophistication in recent years and our armamentarium of tools to treat them has also expanded. Like the rest of the face the eyes age in four ways: Firstly there are the skin changes due to sun exposure, all too common in our sun-drenched part of the world. This can manifest itself as fine lines or discolorations of the skin. These may respond to cosmeceuticals – scientifically-based skin care preparations. In some cases laser resurfacing may be of benefit particularly when the lines are more advanced.

For the lines that are due to recurrent facial expressions such as crow’s feet or frown lines,  injectables can be a very effective treatment. Again it is not to make the face unable to move. A full range of expression should be possible but the over-activity causing deep frown lines and strong crow’s feet can be relaxed in a simple, convenient and natural way.

Brow descent may also be treated with injectables if the heaviness is not severe. This of course avoids an operation but requires injections two to three times per year. Skillful use of this injectable can shape and arch the brow in an attractive way. Surgery is certainly an option for brow descent. The key-hole technique provides rapid recovery, little discomfort and minimal disturbance to hair. In this operation as well as repositioning the brow, the frowning muscles are weakened to make this expression less severe.

Surgery is again the method of choice to deal with excessive skin in the upper lids or lower lids. Reduction or re-shaping of fat pads can be performed at the same operation. The upper eye-lid incision is hidden deep within the eyelid crease while the lower lids can often be approached through the inside of the eyelid, avoiding a skin scar.

Over the last 15 years greater awareness has occurred of the final piece in the ageing ‘jigsaw puzzle’. This is loss of facial volume. The full round cheek and lips of youth turn into thin lines or flat depressions. Unfairly the fitter and leaner you are, the worse this may be. A healthy body may not make for a youthful face.

Around the eyes this volume loss creates grooves below the lower lids or hollowness between the upper lid and the brow or in the temple. Examination of an attractive young face shows a full upper lid, full cheek and a smooth even curve to the lower lids. These attractive features can be restored by use of injectables. Relatively small amounts of product can create a remarkable enhancement to the appearance of the eyes.

Not only are relatively small amounts of the hyaluronic acid injectables required to improve the signs of ageing around the eyes, but in this region the duration of correction achieved with these injectables tends to be longer than in many other parts of the face. Corrections lasting two years or more have been recorded after treatment in areas such as the grooves along the lower lids. While this so called “tear-trough deformity” is a small feature of the face, it has the profound affect to make the eyes look tired and somewhat sad. Small amounts of product used judiciously can cause a remarkable enhancement to the region around the eyes and banish this tired sad look.

As with many cosmetic treatments, careful assessment and appropriate advice are the keys to a successful result. With the many tools available an appropriate treatment program can be selected to suit both your condition and your lifestyle.

So get the right advice, the right treatment and let your eyes shine.

Dr Terrence Scamp is located at Esteem Medi Spa, Level 1, Marina Mirage, 74 Seaworld Drive, Main Beach. To arrange a consultation visit drterrencescamp.com.au or phone 07 5539 1000.

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