Ask Cutis | “I always look tired – what can be done?”


In this special edition of the Ask Cutis blog post series, our registered Nurse Dasha responds to a patient who is frustrated with their tired look. Dasha not only has the practical experience of being a surgical nurse, but she has also undergone many treatments to rejuvenate her eyes, including Fraxel® treatments, blepharoplasty, neuromodulators such as BOTOX COSMETIC® and filler treatments such as JUVÉDERM®. In other words, she’s an authority on eye rejuvenation. Here’s her take on how to give your eyes a makeover.

Patient: “I always look tired. What can be done?”

Dasha: “The first thing I would ask you is, what do you have in mind? Are you talking about bags under your eyes, or sagging upper lids? By finding out what you’re looking for, I can help you find the right solution is for your eyes. What have you researched? What have your friends been talking about?”

Patient: “A lot of my friends have had Botox. Will that fix my sagging eyelids?”

Dasha: “Botox can be used to lift the brows slightly. That will open your eyes a little bit, but if you have real bags under your eyes and really droopy eyelids, you do need surgery in order to get the maximum effect.”

Patient: “Okay. So should I be doing Botox to maintain the benefits of my surgery?”

Dasha: “Usually, Botox is only used for the crow’s feet beside your eyes to diminish those lines. Very little Botox is needed to correct these lines, maybe just a few units on each side. The bunny lines that form wrinkles at the bridge of the nose can be treated as well. That’s all that Botox is used for when correcting aging changes on the eyes specifically.”

Patient: “What about filler? Will that help with the dark circles under my eyes?”

Dasha: “It really depends on why you have the dark circles. Some people have darker skin, and as they get older, their skin naturally gets darker around their eyes. The other reason is that you may have indentations under the eyes that affect how the light reflects off the skin. In this case, a little filler injected at the corner of the eye below the lower lid with the cannula technique that Dr. Lemckert uses will change the way that the light reflects on the eyes. This will really reduce the look of bags and dark circles—especially where overhead lighting is concerned. Overhead lighting really highlights this aging concern.”

Patient: “What about Fraxel over the eyes. Do you think that is helpful?”

Dasha: “It could be helpful if the skin isn’t too deteriorated. Dr. Lemckert puts special eye shields under the eyelids and blocks the nerves at the temples to prevent any discomfort from arising during the treatment, as you cannot freeze the eyelids. Fraxel will help with fine lines, especially for people who are finding that their makeup isn’t going on nicely because of creases from loose skin. Fraxel can help at this first stage of aging.”

Patient: “What do you think has been the most effective thing that you have done for your eyes?”

Dasha: “Without a doubt—blepharoplasty. Your eyelids can be droopy for different reasons. It could be genetic, or if you have suffered from seasonal allergies, the skin of your eyelids can become prematurely aged from rubbing and swelling. When you’re younger, the fluid retention in the eyelids gets reabsorbed, but as you age, the eyes don’t return back to normal. That flexibility is not functioning as well, and then you need surgery.

Blepharoplasty was the best thing I ever did for my eyes—actually for my face, because people think I’m younger than I am, so it must be working.”

Patient: “Did you think the recovery was pretty straight forward?”

Dasha: “It was nothing. There is no muscle cutting. You’re literally losing wrinkled skin; therefore there is no pain when opening and closing your eyes. When the eye bags are treated, we don’t even have to suture that area, it just heals quickly and naturally on its own. There are little tiny pockets of fat that are pulled out that are the size of your little fingernail. Then, once the eyelids are closed, they are compressed. For the upper eyelids, there is one continuous suture that spans the entire crease that is removed after five days. Sometimes people experience minor bruising—I didn’t. I had my surgery on the 20th of December and five days later I was celebrating Christmas with my family without any signs that I had a procedure. I used a little bit of ice for swelling, but I didn’t experience any pain afterwards. My kids were shocked by how minimally invasive it was.”

Patient: “What kind of costs are involved?”

Dasha: “You would need to have a consultation with Dr. Lemckert to determine whether or not you need both your upper and lower eyelids treated. This will of course affect the cost. The good thing about blepharoplasty is that it can be performed under local anaesthetic in our private surgical facility; you are aware of what’s going on during the operation and you feel quite relaxed. This makes it a more affordable surgery because you do not have to pay an anaesthesiologist, and you can expect a speedier recovery with the local anaesthetic.”

Patient: “So it sounds like any reservations about healing are far outweighed by the benefits.”

Dasha: “There’s not really any worry about the healing process unless you are perhaps into your 80s. Then your healing is impaired, your blood circulation isn’t very good and you may be on medications that impede your ability to heal. For a healthy person, it’s nothing. I would say that treatments like Fraxel are more uncomfortable than eyelid surgery with regards to the healing process and less effective.”
So there you have it—Dasha’s very insightful take on the best ways to refresh the eyes. If this has piqued your curiosity about the many ways you can rejuvenate your eyes, we welcome you to book a personal professional consultation; we’ll work with you to create an ideal treatment plan for your unique needs. Contact us to arrange your appointment today.

DISCLAIMER: Individual outcomes, results and number of treatments recommended may vary based on individual patient needs, medical history, and circumstances. Cutis Cosmetic & Laser Centre cannot guarantee exact or permanent results or cures.