It is no surprise that our eyes are the focus of attention when interacting with others. We can infer a person’s age by looking at expression lines around the eyelids, laxity of the skin above and below the eyelashes, and excess tissue that creates bags or shadows (dark circles). These signs also seem to convey a wrong message. Your friends and colleagues may ask if you are upset, sad or just need rest; however, you may feel young and energetic! These “tired-looking eyes” are mainly caused by skin laxity, herniation of fat, and loss of volume. We can start noticing theses signs in our thirties or even our twenties depending on the color of our skin and, of course, our genetic background. Our eyelid specialist can help you target these problem areas to achieve a rested appearance.

At ArteFacial, comprehensive periocular rejuvenation is achieved utilizing surgical and non-surgical options. These options can be used in tandem since they complement each other—for example, lower eyelid blepharoplasty to treat bags under the eyes and Botox to reduce expression lines. The oculoplastic surgeon becomes a sculptor, remodeling the delicate eyelid tissues to suit a patient’s aesthetic needs. His goal is to achieve harmony between the brow and upper and lower eyelids with the midface. This harmony must work with the rest of the facial structures. Results should be natural and appealing to avoid an operated or “done” look.

In the past, plastic surgery consisted of removing tissue such as fat, not realizing that it resulted in an unnatural, sometimes aged appearance. We now understand that volume is a surgeon’s friend. Nowadays, conserving fat instead of excising it is the goal. Dermal fillers and botulinum toxin have become essential to periocular rejuvenation, working alongside surgical procedures to complement them.

Services we offer to achieve comprehensive rejuvenation include:

Upper eyelid blepharoplasty and endoscopic brow lift.

Combined, these two operations work together to rejuvenate the upper third of the face. They help to lift the upper eyelids and recover a youthful brow contour. Additionally, the brow lift will also reposition the brow fat pad over the bony rim, lending more volume to the lateral brow.

Lower eyelid blepharoplasty and midface lift.

The lower eyelid and the cheek are one anatomical unit. Bags under the eyes are often a manifestation of tissue laxity and loss of volume in the cheek. Merely removing the bags will result in additional loss of volume and an aged appearance in many patients. Therefore, it is vital to consider the transposition of fat pockets along with the elevation of the upper midface. This combined effort will blend the eyelid-cheek junction, a characteristic feature of youth.

Complementation of surgery with dermal fillers and botulinum toxin.

Fillers and Botox can be used primarily to treat expression lines and provide volume, respectively. However, they may also be employed to complement the results afforded by surgical procedures. We refer to this strategy as maintenance therapy. Maintenance therapy is essential after a brow lift procedure and lower blepharoplasty. In the former, Botox will help keep the brow depressor muscles relaxed, maintaining a natural brow position for years to come. In the latter, dermal fillers may add volume to the cheek area after a lower blepharoplasty creating a softer and more defined midface contour.

An experienced plastic surgeon has numerous tools at this disposal, surgical and non-surgical, to achieve the results a patient wants. The key lies in selecting the right procedure, or better yet, the right combination of procedures, to meet individual goals. The most desirable plastic surgery is tailor-made.

Before and After Procedure


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