From aging in the eye area to restoring a youthful look
In our everyday life, our facial expressions largely include the area around the eyes. Over time and as the skin's elasticity limit has been exceeded, permanent wrinkles are established which are now visible even at rest, i.e. when the face is expressionless. Heredity plays a primary role as people with thin and dry skin will develop expressive resting wrinkles much faster (the elasticity limit of the skin is very low) but our DNA also determines the anatomy of the area (eg people with strong periocular muscles or strong muscles in the mid-frown area will face periocular wrinkles faster).
Heredity plays the main role in their appearance "dark circles" that affect many patients and in most cases are familial (seen in several family members), while other factors are considered secondary (daily skin care habits, sun exposure).
In the anatomical changes that occur as we age
is the loss of volume in the periocular area and especially in the area of the lower eyelid furrow, inside and under the eye called "valley of tears the tear trough" because there the tears run parallel to our nose. The loss of volume is due to the gradual loss of adipose tissue and while it does not contain pigment it gives the image of "dark circles" due to shading
Volume loss is also seen in the temporal area which affects as it causes the tail of the brow to droop. Also the decrease in skin moisture and elasticity levels will lead to the appearance of fine lines which first become apparent under the eyes where the skin is thinner, but also wrinkles around the eyes in the area known as "crow's foot".
Daily skin care with the application of anti-aging creams, whitening or moisturizing creams specific to the peri-ocular area also plays an important role in the outcome of aging in the peri-ocular area.
Finally, exposure to the sun, especially without protection (sunglasses, sunscreens) enhances the skin aging process on the whole face (photoaging) but especially in the peri-ocular area where the skin is most sensitive
Even dietary factors and smoking play a role in the premature aging of the skin in general and in particular the peri-ocular area.
BOTOX application to correct crow's feet and fine wrinkles under the eye.
Botulinum toxin is the treatment of choice for correcting wrinkles located around the eyes in the area known as "crow's foot". When we have managed to intervene in time before these wrinkles become too deep (because as long as we postpone the treatment and the function of the expressive muscles of the area is prolonged, these wrinkles deepen) the restoration is complete only with the application of botulinum toxin. If they are very deep, we will have a 50-70% improvement with the application of botulinum toxin and if we want an even better result, we will have to supplement with the application of hyaluronic acid.
Before & After Treatment
You can see the course of each treatment in the slider below. By pressing the arrows at the bottom you can see the result per session
First session
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Second session
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Third session
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Hyaluronic application for correction in the peri-ocular area.
Volume loss in this area is mainly due to fat loss. Fat is what fills the eye socket, supports and keeps the skin in the area firm. This loss becomes particularly evident in the area inside and under the eye called the tear trough. The loss of volume results in the appearance of fine wrinkles, the appearance or worsening of "dark circles" as well as the creation of a "bag" in the area under the eye (here we should make a differential diagnosis with cases where the bag is due to lymphatic stasis and fluid retention or in some persons the accumulation of fat in the area)
Also the shape of the eye socket changes as we grow older as the bones of the eye socket area resorb and recede which gives the impression that the eye is coming in backwards (unfortunately we cannot intervene in these bone changes).
Placement of injectable hyaluronic acid in the area helps restore lost volume by immediately correcting the fine wrinkles and his "tear trough". It also significantly reduces the appearance of "black circles" and "bags» in the under-eye area
Also the correction with special hyaluronic acid and adding volume to the cheekbones ("apples") it significantly corrects fine wrinkles around the eyes, while there is also the benefit of correcting the nasolabial fold and the sagging seen in the contour of the lower jaw.
In addition, in the event that the wrinkles in the "crow's feet" area are particularly deep and the application of botulinum toxin cannot provide a complete correction, the additional correction with hyaluronic acid offers the maximum possible result.
By applying botulinum toxin in the mid-frow area (between the eyebrows), in addition to correcting the two vertical wrinkles known as "frown wrinkles", we also achieve a correction of the central degree (head) of the eyebrow. By applying botulinum toxin to end (tail) of the eyebrow we achieve recovery of this area. Finally, with small corrections in the upper part of the forehead, in addition to the treatment of horizontal wrinkles ("wrinkles of denial"), we also achieve a lifting of the central division "body of the eyebrow". To further improve the shape of the eyebrow we can correct it loss of volume of the temporal region with the use of special hyaluronic acid. Finally, a special application on the forehead threads PDO they can also contribute to lifting the eyebrow
The PRP (Platelet Rich Plasma) treatment is based on the use of the patient's own growth factors which are released from the platelets contained in the blood. The growth factors stimulate the skin's fibroblasts to produce collagen and elastin, thus providing skin tightening and thicker, quality skin. Skin cells are also activated in the production of endogenous hyaluronic acid, which retains water molecules, offering hydration to the skin. In addition, they reactivate the adult dormant stem cells of the area, activate the proliferation of cells in the area, resulting in better perfusion of the area
The PRP treatment is done by injection but can accompany and complement a minimally invasive method of microtrauma which is done in the periocular area (microneedling, fractional laser CO2, PDO threads, PLEXR) giving even better results in the application (due to the growth factors) and offering a lot faster recovery times.
The fractional CO2 laser in fractional use makes a selective scan of the entire surface of the skin which we want to improve by creating "microthermal therapeutic zones". It stimulates collagen production and at the same time is a very strong stimulus for skin renewal. A new, better quality skin is achieved, with fewer imperfections and signs of aging such as wrinkles.
In addition, it is advantageous as a treatment over medium and deep chemical peels because it has a much shorter recovery time. On the contrary, deep chemical peels have a much longer recovery time, greater discomfort for the patient, while the result immediately after application is often frightening.
This particular treatment is also enhanced as a result and has faster recovery times when combined in the same session with autologous mesotherapy prp which is injected into the same area
Non-surgical blepharoplasty can be used to rejuvenate and instantly tighten the skin around the eye area, improving the appearance of the skin, shrinking unsightly "bags" and lifting and "opening" the eye. It is a suitable treatment for people with excess skin on the eyelids who want to avoid surgical blepharoplasty.
"Plasma" blepharoplasty treatment works by creating a series of microzones of injury (tiny dots on the skin), which cause an immediate contraction and tightening of the skin fibers to create a lifting, remodeling and rejuvenation ) action. The effect of plasma technology is limited to the surface cells of the skin called "keratinocytes", without damaging the underlying tissues.
This particular treatment is also enhanced as a result and has faster recovery times when combined in the same session with autologous mesotherapy prp which is injected into the same area
As with any treatment, a thorough consultation with your doctor should be done to see if this is the right solution for you.
In this application we use fully absorbable monofilaments or screw PDO threads, short length with very fine needle, due to the fact that the skin of the area is very thin with very rich vascularity. These threads are placed in such a way as to form a mesh that supports the periocular area which is constantly under the influence of forces from the muscles during expressiveness. In addition, these threads with the process of "foreign body reaction" cause the skin to produce its own collagen and elastic fibers which surround the thread that was placed and strengthen it. In this way, the initial anatomical support of the area is strengthened by the thread.
H application of threads grid support PDO in periocular area offers important additional improvement as well longer duration of effect in the initial application of botulinum toxin and hyaluronic acid.
Also, we apply the support threads as monotherapy in cases where they do not wish to apply botulinum toxin or hyaluronic acid, in which case we offer significant anatomical support to the area with the threads.
With a special application on the forehead, PDO threads can also contribute to the lifting of the eyebrow
Thread application can also be combined with application autologous PRP mesotherapy which significantly enhances the therapeutic effect.
The problem of "dark circles" (medically called primary periocular hyperplasia) is mainly due to hereditary factors and is more common in people with very thin skin, almost transparent skin on the lower eyelids, without enough subcutaneous fat combined with increased subcutaneous vascularity. The result is to distinguish the subcutaneous plexus of vessels, imparting a dark blue-purple hue to the skin which translates to a distressed, "sleepless", sad or aged appearance. Of course, when someone doesn't get enough sleep, the problem gets worse, because there isn't good blood circulation in the area. The same happens on "period" days. So we suggest adequate sleep (ideally the patient should sleep with the head slightly raised to facilitate the drainage of lymph-fluids from the area of the lower eyelids) and proper diet (avoidance of salt, foods rich in antioxidant agents and adequate water intake), smoking cessation, reasonable use of alcohol combined with the therapeutic interventions we can do to help:
Autologous mesotherapy PRP: PRP therapy is based on the use of the patient's own growth factors which are released from the platelets contained in the blood. The growth factors stimulate the fibroblasts of the skin to produce collagen and elastin, thus offering skin tightening and a thicker and better quality. Skin cells are also activated in the production of endogenous hyaluronic acid, which retains water molecules, offering hydration to the skin. The thicker and quality skin makes the skin vessels less visible resulting in an improvement in the image of dark circles. The PRP treatment is done by injection but can accompany and complement a minimally invasive method of microtrauma which is done in the periocular area (microneedling, fractional laser CO2, PDO threads, PLEXR) giving even better results in the application (due to the growth factors) and offering a lot faster recovery times.
Heterogeneous mesotherapy: Mesotherapy is an effective way to remove dark circles from the eyes. It improves the texture of the skin so we infuse substances like caffeine and ginko biloba, which provide hydration and lighten the dark tone. In another treatment protocol we use vitamin C in combination with DMAE and hydrating hyaluronic acid. Complete protocols require 4-6 treatment sessions. It is good to have a consultation session beforehand to decide which protocol is most suitable for each patient.
Hydrating Hyaluronic Acid: A very effective treatment is the use of injectable hyaluronic acid in the area of the lower eyelids. This hydrates the skin, which thickens and increases the distance of the skin from the vessels in the area, thus changing the shading of the lower eyelid. The result is usually impressive, but at least three treatment sessions are required.
Frax–Peel: This combination application is the latest in the field of piles. The micro trauma that creates the microneedling creates "gateways" for the chemical peel which achieves a much better penetration into the skin. So we can use milder peels which are completely safe, have very controlled exfoliation and very little skin irritation after application, can be done even in the summer months and have no recovery-recovery time, which with this combined application penetrate deeper and they have a much better effect similar to that of very strong chemical peelings. The peels we use are usually citric (derived from lemon) or combined citrate-mandelic (derived from bitter almond)
H application of threads grid support PDO in periocular area offers important additional improvement as well longer duration of effect in the initial application of botulinum toxin and hyaluronic acid.
Also, we apply the support threads as monotherapy in cases where they do not wish to apply botulinum toxin or hyaluronic acid, in which case we offer significant anatomical support to the area with the threads.
With a special application on the forehead, PDO threads can also contribute to the lifting of the eyebrow
Thread application can also be combined with application autologous PRP mesotherapy which significantly enhances the therapeutic effect.
These creams contain whitening substances with hydroquinone being the strongest of them (but it is irritating to the skin and its use should be avoided during the sunny months). Other whitening substances are azelaic acid, kojic acid, while it may also contain vitamin C. The whitening effect contributes significantly to the treatment of dark circles. The use of the whitening cream can precede the minimally invasive microtrauma treatments (microneedling, fractional laser CO2, PDO threads, PLEXR) preparing the area for the treatment and then its use continues in the intervals of the invasive treatments. We start re-using the cream when the irritation from the invasive treatment has passed (after 5-7 days). When there is sunshine, sunscreen should be used in the morning
There are cases where dark circles are due to dermatological diseases. One chronic atopic eczema in the area of the eyelids it causes itching and repeated rubbing on the delicate skin of the area causes hyperpigmentation due to pigment deposition (hemoglobin which is released from injured skin capillaries when we rub our eyes). The same causes one irritant or allergic contact dermatitis in the eyelid area which is usually due to cosmetics (here to emphasize the importance of removing make-up every night with specialized make-up remover products). In these cases, our main concern is the treatment of the dermatological condition that causes the problem, followed by the improvement of the aesthetic problem
Other pathological causes include: anemias , hormonal changes-premenstrual syndrome or menopause (which are manifested by edemas, i.e. swelling of the eyelids). The eye allergies (eg conjunctivitis) As well as dry eye cause increased friction in the area by the patient resulting in pigment deposition. Also diseases related to the nose such as chronic allergic rhinitis, sinusitis, crooked diaphragm they cause chronic congestion due to poor drainage of tears in the nose resulting in venous congestion and the eyelids appearing puffy and black from insufficient oxygenation. In all these cases, the main goal is to treat the primary pathogenic cause.
Autologous mesotherapy PRP: PRP therapy is based on the use of the patient's own growth factors which are released from the platelets contained in the blood. The growth factors stimulate the fibroblasts of the skin to produce collagen and elastin, thus offering skin tightening and a thicker and better quality. Skin cells are also activated in the production of endogenous hyaluronic acid, which retains water molecules, offering hydration to the skin. The thicker and quality skin makes the skin vessels less visible resulting in an improvement in the image of dark circles. The PRP treatment is done by injection but can accompany and complement a minimally invasive method of microtrauma which is done in the periocular area (microneedling, fractional laser CO2, PDO threads, PLEXR) giving even better results in the application (due to the growth factors) and offering a lot faster recovery times.
Heterogeneous mesotherapy: Mesotherapy is an effective way to remove dark circles from the eyes. It improves the texture of the skin so we infuse substances like caffeine and ginko biloba, which provide hydration and lighten the dark tone. In another treatment protocol we use vitamin C in combination with DMAE and hydrating hyaluronic acid. Complete protocols require 4-6 treatment sessions. It is good to have a consultation session beforehand to decide which protocol is most suitable for each patient.
Hydrating Hyaluronic Acid: A very effective treatment is the use of injectable hyaluronic acid in the area of the lower eyelids. This hydrates the skin, which thickens and increases the distance of the skin from the vessels in the area, thus changing the shading of the lower eyelid. The result is usually impressive, but at least three treatment sessions are required.
Frax–Peel: This combination application is the latest in the field of piles. The micro trauma that creates the microneedling creates "gateways" for the chemical peel which achieves a much better penetration into the skin. So we can use milder peels which are completely safe, have very controlled exfoliation and very little skin irritation after application, can be done even in the summer months and have no recovery-recovery time, which with this combined application penetrate deeper and they have a much better effect similar to that of very strong chemical peelings. The peels we use are usually citric (derived from lemon) or combined citrate-mandelic (derived from bitter almond)
H application of threads grid support PDO in periocular area offers important additional improvement as well longer duration of effect in the initial application of botulinum toxin and hyaluronic acid.
Also, we apply the support threads as monotherapy in cases where they do not wish to apply botulinum toxin or hyaluronic acid, in which case we offer significant anatomical support to the area with the threads.
With a special application on the forehead, PDO threads can also contribute to the lifting of the eyebrow
Thread application can also be combined with application autologous PRP mesotherapy which significantly enhances the therapeutic effect.
These creams contain topical retinoids (retinol, adapalene, tretinoin, tazarotene) which are derivatives of vitamin A with proven value in skin renewal and antiaging. Another alternative are the creams that contain them fruit acids (AHA, BHA) which cause a mild peeling renewing the skin in the area.
But useful ingredients are the Vitamin C that gives shine, vitamin K to combat dark circles, the coenzyme Q10 which has an antioxidant effect, hyaluronic acid which hydrates, the caffeine to stimulate and stimulate microcirculation, aloe for soothing action, chamomile for anti-inflammatory action, gingo biloba to enhance microcirculation.
Before the minimally invasive microtrauma treatments (microneedling, fractional laser CO2, PDO threads, PLEXR) we stop the treatment with retinoid or acid fruit creams. We start re-using the cream when the irritation from the invasive treatment has passed (after 5-7 days).
When there is sunshine, sunscreen should be used in the morning
There are cases where dark circles are due to dermatological diseases. One chronic atopic eczema in the area of the eyelids it causes itching and repeated rubbing on the delicate skin of the area causes hyperpigmentation due to pigment deposition (hemoglobin which is released from injured skin capillaries when we rub our eyes). The same causes one irritant or allergic contact dermatitis in the eyelid area which is usually due to cosmetics (here to emphasize the importance of removing make-up every night with specialized make-up remover products). In these cases, our main concern is the treatment of the dermatological condition that causes the problem, followed by the improvement of the aesthetic problem
Other pathological causes include: anemias , hormonal changes-premenstrual syndrome or menopause (which are manifested by edemas, i.e. swelling of the eyelids). The eye allergies (eg conjunctivitis) As well as dry eye cause increased friction in the area by the patient resulting in pigment deposition. Also diseases related to the nose such as chronic allergic rhinitis, sinusitis, crooked diaphragm they cause chronic congestion due to poor drainage of tears in the nose resulting in venous congestion and the eyelids appearing puffy and black from insufficient oxygenation. In all these cases, the main goal is to treat the primary pathogenic cause.
Autologous mesotherapy PRP: PRP therapy is based on the use of the patient's own growth factors which are released from the platelets contained in the blood. The growth factors stimulate the fibroblasts of the skin to produce collagen and elastin, thus offering skin tightening and a thicker and better quality. Skin cells are also activated in the production of endogenous hyaluronic acid, which retains water molecules, offering hydration to the skin. The thicker and quality skin makes the skin vessels less visible resulting in an improvement in the image of dark circles. The PRP treatment is done by injection but can accompany and complement a minimally invasive method of microtrauma which is done in the periocular area (microneedling, fractional laser CO2, PDO threads, PLEXR) giving even better results in the application (due to the growth factors) and offering a lot faster recovery times.
Heterogeneous mesotherapy: Mesotherapy is an effective way to remove dark circles from the eyes. It improves the texture of the skin so we infuse substances like caffeine and ginko biloba, which provide hydration and lighten the dark tone. In another treatment protocol we use vitamin C in combination with DMAE and hydrating hyaluronic acid. Complete protocols require 4-6 treatment sessions. It is good to have a consultation session beforehand to decide which protocol is most suitable for each patient.
Hydrating Hyaluronic Acid: A very effective treatment is the use of injectable hyaluronic acid in the area of the lower eyelids. This hydrates the skin, which thickens and increases the distance of the skin from the vessels in the area, thus changing the shading of the lower eyelid. The result is usually impressive, but at least three treatment sessions are required.
Frax–Peel: This combination application is the latest in the field of piles. The micro trauma that creates the microneedling creates "gateways" for the chemical peel which achieves a much better penetration into the skin. So we can use milder peels which are completely safe, have very controlled exfoliation and very little skin irritation after application, can be done even in the summer months and have no recovery-recovery time, which with this combined application penetrate deeper and they have a much better effect similar to that of very strong chemical peelings. The peels we use are usually citric (derived from lemon) or combined citrate-mandelic (derived from bitter almond)
H application of threads grid support PDO in periocular area offers important additional improvement as well longer duration of effect in the initial application of botulinum toxin and hyaluronic acid.
Also, we apply the support threads as monotherapy in cases where they do not wish to apply botulinum toxin or hyaluronic acid, in which case we offer significant anatomical support to the area with the threads.
With a special application on the forehead, PDO threads can also contribute to the lifting of the eyebrow
Thread application can also be combined with application autologous PRP mesotherapy which significantly enhances the therapeutic effect.
THE EPIfactor® is a bioidentical epidermal growth factor. It is a protein with the main property of activating fibroblasts. Fibroblasts produce collagen and elastin, giving the skin regeneration and firmness. In this cream, the patient's own growth factors obtained through the procedure are incorporated and survive autologous PRP mesotherapy. The growth factors of PRP further activate the skin fibroblasts and additionally the skin cells to produce their own endogenous hyaluronic which retains water and provides deep hydration to the skin
The application of the autologous cream is recommended in the intervals between the injection treatments in order to enhance and prolong the results of the applications of botulinum toxin, hyaluronic acid, threads and autologous PRP mesotherapy.