We Asked an Eye Expert Our Top 10 Eye Rejuvenation Questions

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With all the creams, serums, eye masks and gadgets out there to refresh the eye area, it’s hard to know what to use or how to treat the delicate skin around your eyes. Whether it’s droopy lids, under-eye bags, crow’s-feet, dark circles or overall puffiness, it seems like everyone has a different problem, and the solutions keep growing every day. To find out exactly what we need to be doing, or avoiding doing, to keep our eyes looking fresh, we reached out to Short Hills, NJ oculoplastic surgeon Baljeet Purewal, MD. Here, she tells us how to revive and rejuvenate one of the first areas to show visible signs of aging

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NewBeauty: What results can you yield with a good eye cream?
Dr. Purewal: Many over-the-counter eye creams will boast about dramatic results like improving dark circles and puffy lower lids. But, unfortunately, the results in real life are usually less impressive. However, for dark circles caused by pigmentation in the skin, topical products in higher strengths and concentrations can help to lighten the skin. One can also use eye creams as a wrinkle preventive measure by moisturizing and nourishing this very thin skin. 

NB: What are the best ingredients to treat the under-eye area at home?
Dr. Purewal: For dark circles and fine lines, look for a medical-grade eye cream with ingredients such as retinol and koijic acid in combination with peptides and antioxidants such as vitamin C, E and green tea. I also really like SkinMedica TNS Essential Serum for the face—it works great to soften crow’s-feet. 

NB: When is a good age to start using an eye cream, and why should you start using one if you don’t already?
Dr. Purewal: Early 20s is a good time to start using an eye cream to keep the area hydrated and prevent fine lines from forming. The eyelid skin is the thinnest skin on the body and there is constant movement from blinking. It’s also subjected to environmental stressors like the sun, wind and allergies. It is important to nourish this delicate skin to maintain its elasticity. 

NB: A big beauty myth is that Preparation H reduces puffiness under the eyes. Do you recommend using it? 
Dr. Purewal: There are much better options for temporary relief from under-eye puffiness than using Preparation H. This is definitely a bad idea and a product you want to avoid getting in your eyes. 

NB: Can at-home light therapy devices make any improvements to the eye area? 
Dr. Purewal: I would shift my home care commitment to regularly using a good eye cream, avoiding excessive sun exposure, staying hydrated and using light Botox Cosmetic treatments, which will allow collagen remodeling in the crow’s-feet area and short- and long-term improvement in skin. 

NB: When should someone consider getting filler over surgery to rejuvenate the eye area or correct under-eye bags or hollows?
Dr. Purewal: Fillers are a temporary fix and must be repeated yearly. They work best when there is not a great amount of fat prolapse to camoflauge and the skin is not very loose. The results are immediate and in combination with cheek filler can work great to improve the appearance of the midface area. If you are seeking a more permanent result, surgery should be considered. Surgery can address extra skin on the lower lids and “dark circles” created by shadows from fat prolapse. 

NB: Are there any off-label treatments that might be risky or not worth trying yet?
Dr. Purewal: Yes, Kybella is FDA-approved to eliminate fat under the chin and NOT under the eyes. Due to the proximity of the eyeball, I think it is not worth risking off-label Kybella treatments to this area, which some people are having done now even though there aren’t any studies or clinical trials to back it up. 

NB: How long do blepharoplasty results really last and is a follow-up surgery recommended?
Dr. Purewal: The results from surgery can last from 10–15 years. Some people have a genetic predisposition for bags under their eyes or heavy lids and choose to have the surgery done in their early 30s. For these patients, they may choose to repeat the surgery at a later age as the skin and tissue around the eyes continue to age further. 

NB: Which surgical or nonsurgical trends are you seeing at your practice?
Dr. Purewal: Patients are more aware now of how Botox Cosmetic can work to rejuvenate the periorbital area. They will often ask for Botox to elevate their brows. This is called a “chemical browlift” and works beautifully to frame the brows and enhance the appearance of the eyes. We are also seeing patients coming in at an earlier age—around the mid 20s and early 30s—for a light treatment of Botox to maintain and prevent eyelid wrinkles. 

NB: What kind of combination therapies do you use to rejuvenate the eye area?
Dr. Purewal: For patients who are not surgical candidates or are not ready to undergo surgery, we like to combine Botox and fillers with Ultherapy high-frequency ultrasound to lift and tighten the tissue.

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