
Many patients complain about the appearance of their eyes. The loss of elasticity of the eyelids, the crumpled appearance and the appearance of wrinkles at this level are a frequent request for consultation. Eyelid skin is one of the first areas that shows the signs of aging. Many factors can contribute to the quality of the skin in this area: skin pigmentation, skin elasticity, reduction of dermal thickness over the years, moreover the bone and muscle changes in the suborbital zone.
CAUSES
Several factors are responsible for the appearance of lines and wrinkles in the upper and lower eyelids.
- Reduced dermal thickness : with time, the destruction of hyaluronic acid and collagen overtakes their production the dermis is essential for tone and skin thickness and when it becomes thinner, the skin becomes wrinkled and small wrinkles begin to appear.
- Loss of elasticity : elastin production is reduced over time. The eyelids lose their elasticity and fall.
- Repeated movements : the expressions cause dynamic wrinkles, then static, which at the histological level corresponds to epidermal and superficial dermal breaks.
- Loss of volume :at this level, ptosis-fat melt and bone reabsorption cause a reduction of the malar support, which causes tissue sagging.
POSSIBLE TREATMENTS

Laser erbium or CO2
The laser stimulates the creation of a thicker dermis by warming and ablation processes. Depending on the treatment modality chosen. With the split modality the result is an improvement of the fine lines (the percentage of improvement is established during the consultation), 4 sessions are recommended, the social eviction and down time is short 3-5 days. This is the only treatment (among the listed) possible for the upper eyelid. With the continuous modality the result is perfect, one session is enough, the social eviction is about 7-10 days and then the skin remains pink during 3 months.
Medium or deep peel
We utilize the TCA peel to reach the middle dermis. One session is enough, in some cases a second is to recommended. The principle is identical to that of the continuous ablative laser, dermal layers are removed to obtain a new, denser skin. The suites are the same. On this fragile skin I prefer the laser chemical agents peeling.


Hyaluronic Acid
The loss of bone and fat volume, at the orbital and temporal level, is treated by injection of hyaluronic acid. This is a traction on the skin which allows to stretch wrinkles.
Threads
The mesothreads and or threads are inserted directly into the wrinkle and then meshed at the level of the lower eyelid to thicken the dermis and thus reduce wrinkles. The disadvantage is represented by the high rate of hematomas.

BEFORE AND AFTER PICTURES


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