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There is a kind of aging that when you’re editing photos, you can’t help but gently push the corners of your eyes up, reducing the sagging, and immediately reducing the fatigue.
In addition to this, common signs of eye aging also include: loose eyelids, narrowed double eyelids (or becoming multi-eyelids) , more prominent eye bags, and so on. These signs can also make a person look less spirited, usually becoming more apparent after the age of 35.
Today, let’s discuss how to improve when we observe these changes.
We categorize the signs of eye aging into three major categories:
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Periocular skin laxity: Mainly manifested as drooping eyelids, narrowed double eyelids, triangular eyes, smaller eyes, partial coverage of the pupil, etc.;
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Fine line formation: Including static and dynamic wrinkles.
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Orbital depression: Mainly manifested as upper eyelid depression, lower eyelid depression (tear trough) , eye bags, dark circles, etc.
Note: Dynamic wrinkles, i.e., wrinkles that appear “only when moving,” such as crow’s feet at the corners of the eyes when laughing (smile lines) , frown lines when frowning (forehead lines) , and forehead wrinkles when raising eyebrows (brow lines) , caused by the contraction of expressive muscles pulling the skin. Static wrinkles, i.e., wrinkles that can be seen “even without expressions,” such as dry lines, fine lines, related to decreased skin elasticity and toughness. In addition, dynamic wrinkles can promote the appearance of static wrinkles.
For the above signs of eye aging, there are usually 3 types of improvement strategies:
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Promote skin collagen regeneration
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Reduce the activity of the muscles of expression
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Restore subcutaneous volume
Approach 1
Promote Collagen Regeneration Around the Eyes
Photoelectric Treatment, Hyaluronic Acid Treatment
In simple terms, it is to promote the generation of collagen in the skin, thereby improving skin laxity, fine lines, and other conditions.
I. Photoelectric Treatment
1. Fractional Laser
There are two types of fractional lasers, non-ablative fractional lasers and ablative fractional lasers.
In medical aesthetics, fractional lasers are a common choice. They are mainly divided into two types: Non-ablative fractional laser (NAFL) and Ablative fractional laser (AFL).
Their core principles are similar: by creating microscopic thermal injuries with lasers, it triggers the skin’s self-repair mechanism, stimulating the contraction and regeneration of collagen, achieving the effect of improving skin texture, reducing fine lines, and tightening the skin.
The difference between the two lies in whether the “epidermis is ablated” or not.
Left: Ablative Fractional Laser; Right: Non-ablative Fractional Laser
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Non-ablative Fractional Laser (NAFL)
Does not ablate the epidermis, the skin surface remains intact during treatment. Therefore, its recovery period is short, with fewer adverse reactions, but it usually requires multiple treatments to achieve the desired effect.
In the treatment of periocular wrinkles, commonly used non-ablative fractional laser wavelengths include 1540nm, 1550nm, 1565nm, 1927nm, etc. These near-infrared laser wavelengths primarily target water in the skin, effectively promoting collagen synthesis by producing controllable thermal effects in the dermis, thereby smoothing fine lines and improving laxity.
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Ablative Fractional Laser (AFL)
Removes part of the epidermis, forming tiny ablation zones, usually more noticeable effects in a single session, but stronger irritation, and a relatively longer recovery period.
In the treatment of periocular wrinkles, commonly used ablative fractional lasers include 10600nm CO₂ fractional laser and 2940nm Er:YAG fractional laser. By precisely vaporizing part of the epidermis and dermis, it triggers deep skin repair mechanisms, effectively stimulating the regeneration and reorganization of collagen.
However, its postoperative recovery period is longer than other energy devices, and there is a risk of persistent erythema and pigmentation in darker skin types. Therefore, before treatment, it is recommended to communicate fully with the doctor, based on personal skin type, recovery time, and treatment expectations, to jointly develop an appropriate treatment plan.
2. Radiofrequency Treatment
Common radiofrequency devices used for periocular rejuvenation mainly include: Eye Thermalage, Eye Gold Microneedle.
Radiofrequency is suitable for people of all skin types and colors, and can achieve satisfactory results in the age range of 30 to 65.
Its working principle can be understood as a “from the inside out” thermal effect: radiofrequency current penetrates the epidermis and, when encountering resistance in the dermis, is converted into heat energy. This causes the dermal collagen to contract and denature, and initiates a wound healing response, promoting collagen remodeling and regeneration, and also stimulates fibroblasts to induce collagen synthesis.
Studies have shown [5] that the collagen remodeling effect after a single radiofrequency treatment can last for 4 to 6 months. In addition, radiofrequency has a minimal impact on epidermal melanin, making it suitable for people of different skin colors.
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Eye Gold Microneedle
This is a type of fractional radiofrequency, which achieves facial rejuvenation through the following triple action:
1) Fractional microneedle mechanical stimulation: Improves skin texture and promotes renewal.
2) Precise thermal coagulation: Forms controllable thermal injuries in the dermis, initiating repair.
3) Microchannel effect: Postoperative application of topical medications can increase transdermal absorption and enhance efficacy.
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Eye Thermalage
This is one of the earliest radiofrequency devices used for facial rejuvenation. Its smart pulse technology (AccuREPTM) can automatically recognize the impedance differences of the skin at different sites and adjust the energy output in real-time. This makes the thermal effect of the treatment more precise and stable, helping to enhance the effectiveness while better ensuring treatment safety and reducing the incidence of adverse reactions. [7] .
Studies have shown [8] that six months after a single treatment, the density and structure of dermal collagen and elastic fibers are still improved.
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Periocular Hyaluronic Acid Treatment
By injecting collagen hyaluronic acid (for example, Type III collagen hyaluronic acid) , direct collagen supplementation is achieved. These hyaluronic acid products have multiple mechanisms such as activating endogenous synthesis, regulating collagen structure, and antioxidant and anti-inflammatory effects. When applied to the periocular skin, they can improve skin laxity and fine lines.
Approach 2
Reduce Ocular Muscle Activity
Dynamic Wrinkles “Emergency Brake”
That is, wrinkle treatment, inhibiting muscle activity, relaxing over-contracted muscles, thereby reducing dynamic wrinkles.
Periocular Muscles
In addition, through proper injection points, it can also achieve the effect of lifting eyebrows and enlarging eyes. [9] .
However, wrinkle treatment only prevents the expression muscles from over-contracting, not completely inhibiting them. This requires high precision in dosage and technique. Our goal is to avoid “inability to make expressions” or “stiff expressions.” .
If you want to ask, is it feasible to voluntarily inhibit muscle activity by reducing laughter, frowning, etc.? It is feasible, but for most friends, it is too difficult.
Approach 3
Restore Periocular Volume, Fill Depressions
Currently, the main materials used for tear trough filling in clinical practice are hyaluronic acid, collagen, and autologous fat , each with its own material characteristics and applicable scenarios.
1. Hyaluronic Acid
In periocular rejuvenation treatments, hyaluronic acid filling is currently one of the most widely used options.
Hyaluronic acid naturally exists in human skin and has good biocompatibility and water retention capabilities. When injected into the periocular area, it effectively replenishes volume and enhances fullness, while also playing a long-lasting moisturizing effect. Its advantages are good support, longer duration, and reversible adjustments with enzymes when necessary.
However, the thin skin and rich blood vessels in the periocular area may also present some special situations when injecting hyaluronic acid, such as:
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Tyndall phenomenon: local skin presents a light blue tone;
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Local unevenness or hard lumps;
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Unnatural appearance after filling.
These situations are closely related to product characteristics, injection depth, and physician technique.
In clinical practice, hyaluronic acids with different physical properties are suitable for different areas:
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Some are suitable for deep support, such as improving orbital depression and restoring volume loss;
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Others are suitable for shallow precise filling to improve fine lines.
Therefore, in periocular treatments, doctors often choose hyaluronic acid products with corresponding characteristics based on specific problems (whether it is depression or fine lines) , injection depth, and expected effects, to achieve a natural and long-lasting rejuvenation effect.
2. Collagen
Collagen is similar to the body’s own collagen, usually milky white in color, with good biocompatibility, biodegradability, and bioactivity.
The effect of collagen protein injection is presented through four stages: immediate supplementation, dehydration tightening, collagen regeneration, and skin texture restoration.
Not only does it have filling effects, but its milky white non-transparent characteristic can also physically cover and improve dark circles and under-eye circles.
Moreover, the injected collagen forms a mesh-like scaffold, providing a growth environment for the regeneration of the body’s own collagen. Later, collagen will gradually metabolize into amino acids, continuously providing nutrition for the skin, restoring skin elasticity; and inhibiting tyrosinase activity, achieving the effect of reducing melanin production and brightening the skin tone.
However, it has 3 disadvantages:
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It has the risk of sensitization, but the allergy rate is low, usually not exceeding 3%;
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The duration is relatively short (requires regular injections) ;
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Lacks deep support.
Therefore, in cases of severe orbital volume loss, hyaluronic acid can be used in combination for deep support, and then collagen can be used for supplementary modification to achieve complementary advantages. [11] .
3. Autologous Fat
Autologous fat facial filling is done by extracting fat from other parts of the body, purifying it into fat particles, and then filling it into the depressed areas of the face. The advantage of fat filling is that it can maintain the filling effect for a long time, with no rejection reaction and a low incidence of complications.
However, this surgical operation is relatively complex, requiring three steps:取材, purification, and injection, the recovery period is relatively long, there is uncertainty about the survival rate of fat, and multiple injections may be required to achieve the desired effect; if not injected properly, complications such as fat nodules, unevenness, or fat liquefaction may occur. [13] .
Summary
These are all means to interpret and modify aging cautiously. You may wonder, which method is the best? Which has the highest cost-performance ratio?
However, there is no so-called “best” one, only the “most suitable” one for oneself.
Anti-aging is a choice. Professional doctors also need to provide options for photoelectric, radiofrequency, and injection based on specific situations and needs, and inform the pros and cons of each option. Only with full understanding can one make a more composed decision that suits oneself.
Peer Review Expert Zhong Hua
Distinct Dermatology Physician Ph.D. from the Third Military Medical University
References
