There are two approaches to rejuvenating the upper face: non-surgical and surgical.
A non-surgical approach involves skin resurfacing, botox injections, and injection of fillers or platelet rich plasma. A non-surgical approach can camouflage loss of subcutaneous tissue volume, temporarily reduce wrinkles, and improve the surface of the skin. However, this approach has limitations when it comes to correcting sagging skin.
When the aging process has advanced to the point that significant reshaping of the eyebrows and forehead, together with removal of bags under the eyes is desired, surgical methods are safest and the most effective. Surgery is more effective because it creates the largest, permanent improvement. Ideally, a patient seeking rejuvenation for the upper face should consider a specialist offering surgical and non-surgical solutions in order to obtain the best result.
In patients with marked hooding of the upper eyelids and deeply seated eyes, the most beneficial correction will reposition the eyebrows. Often patients will visit a specialist surgeon to correct an appearance of tiredness, and the surgeon will remove excess skin from the eyelids. This however will not result in the desired effect. At times, this procedure may even prevent proper correction in the future. It has to be emphasized that reshaping the eyebrows, not excessive lifting, is the right approach to avoid a surprised and startled facial expression.
Lower eyelids fullness (bags under the eyes) may become apparent in early age with genetic predisposition in some individuals. In these instances, where there is still good elasticity of the skin and the absence of wrinkling, correction may be done by transconjunctival (an incision inside the eyelid) approach. In cases where the bags under the eyes are associated with wrinkling of the skin, a transconjunctival approach may be combined with laser resurfacing of the eyelid. The downside of this combination is that post-op recovery is prolonged and in some skin types changes in skin pigmentation can occur. The best approach is to use an incision close to the eyelash margin which results in invisible scarring with very short post-op recovery. The benefit of this approach is that the amount of skin tightening can be more precisely determined.
Upper facial rejuvenation is a highly desired corrective procedure with a beneficial impact because the eye is first drawn to this portion of the face. As such, correction of the framing of the eyes can lead to a much more youthful appearance. Upper facial rejuvenation can be carried out at the same time as lower facial and neck corrections.