Eyelid Pearls
By Peter T. Pacik, MD, FACS

I recently returned from the annual national meeting for the American Society of Plastic Surgery where over 300 exhibitors pitched the latest and greatest with information ranging from technology to skin care. Educational meetings met from 7 a.m. to 6 p.m. and I had the privilege of presenting my research on pain control catheters following breast enlargement.¹

Eyelid Surgery
This year, much time was spent discussing advances in eyelid surgery. Excellent courses were given; lectures and panel discussions enhanced our understanding of new concepts and new techniques.

The following statistics for lower eyelid cosmetic surgery helped define what most of us know to be true:

• 80% of the benefit is due to fat removal (bags)
• 10% results in eyelid tightening
• Only 10% improves lower lid wrinkling

Most people will develop lower eyelid wrinkling at some point in their lives—some earlier than others, often due to genetics, smoking or sun damage. When performing lower eyelid surgery, the amount of skin removal is usually no more than a few millimeters. If more is taken, the lower lids may be pulled down, as the delicate lower lid skin cannot support the heavy cheek skin.

The Efficacy of Eye Creams
I no longer perform lower eyelid surgery for pure wrinkling and/or crinkling of the eyelid skin. I usually treat these patients with eye creams. Patients with more severe wrinkling or crinkling are treated with eye creams and resurfacing. Patients with dark undereye circles are treated with skin lightening hydroquinone products such as Glyquin-XM or Obagi Nu-Derm Clear, which will work well if the pigment is not too deep.

The most profound result of eye creams is that they can help smooth and tighten the lower lids. Results are often noted after a few weeks and continue to improve dramatically over time. When started at an earlier age (30's), at the very beginning of fine wrinkles, you can help prevent the inevitable sagging of the lower eyelids.

I continue to be amazed by the benefits for my own eyes. Unfortunately I inherited a "hound dog" gene for my eyes that caused them to wrinkle and sag over time. Now, after 3 years of using eye cream, I wake up with smooth, youthful-looking eyes!

	Front	Profile	Detail
Before Views
After Views

A brief comment regarding the use of eye creams
Eye creams may cause some initial irritation (burning or redness). As with any product, test it first by rubbing a small amount on the back of your hand. If there isn't any reaction (redness), use sparingly on the lower lids. The upper lids can be treated also, but be sure to avoid getting these creams into your eyes. Use every 2-3 days. Then as the skin becomes conditioned, use daily and then twice a day. Used faithfully, you will see the difference in your own eyes!

May you skin be healthy and bright and reflect the radiance of your soul.

1. "Pain Management in Augmentation Mammaplasty: A Randomized Comparative Study of the Use of a Continuous Infusion Versus Intermittent Bolus of a Local Anesthetic," American Society of Plastic Surgeons ­ San Diego, California ­ October 29, 2003.