With so many designers in on the act, glasses are now the cool fashion statement that renders Dorothy Parker’s acerbic ditty short-sighted. (Hipster boys not only make passes, but wear specs themselves, I’m assured.) But to 4.2 million squinting Britons, contact lenses still mean facial liberation. It’s a pity, then, as you enjoy your vision sans frontières, that no one warns you of one potentially disfiguring risk down the line.
Ptosis, or droopy eyelids, affects around 20 per cent of those who have pulled, rubbed and otherwise stretched their lids while inserting and removing their rigid gas-permeable lenses for 30 years or more (I’ve worn mine for a staggering 50). It’s not known why, but usually one lid droops more than the other so that in addition to the obvious asymmetry, the result is a dull, weary expression with no youthful glint in the affected eye. It wasn’t until a photoshoot some five years ago that I realised my own, sleepy droop had been developing stealthily – seeing yourself in pictures is the usual wake-up call, I’m told. A bereavement earlier this year has worsened it: research indicates that shock and stress can trigger significant facial ageing “steps” and, sadly, I’m proof.
However, the thought of a blepharoplasty – the standard excision for lazy, hooded lids – is daunting to a surgery virgin like myself, so it’s a relief that there’s a less incisive alternative. A müllerectomy (from £4,500) is the removal of the Müller’s muscle inside the lid that has progressively weakened and detached. It won’t treat the excess skin of hooded lids, but it’s a permanent scar-free lift that banishes that sad, ageing look and, according to oculofacial plastic surgeon Dr Costas Papageorgiou, I was an ideal candidate. “A müllerectomy doesn’t involve external incisions and has a more predictable outcome in terms of eye contour,” he reassured me. To demonstrate and check if my Müllers were actually healthy, he dropped muscle‑stimulating phenylephrine into my eye and within minutes the lid lifted – I was convinced.
Nevertheless, as YouTube videos confirm, this procedure is not for the fainthearted. On the day, while I was blissfully oblivious thanks to some light sedation, Dr Papageorgiou made a 10mm incision on the inside of my lid to create a 2mm lift. An hour later I was sipping tea and waiting for my taxi. By the next morning the lid had swollen around its suture and the start of a lovely black eye was evident, although mercifully, there was no real pain. Downtime, I was told, would be minimal, but I confess that I hid away, cold-packing my considerable shiner for a week until the suture was removed, along with the soft medical contact lens protecting my cornea. After that, both swelling and bruising subsided rapidly and now, two weeks later, my eyes are almost perfectly symmetrical. In three months, the healing will be complete, but I’m already delighted. I may have lost my surgical virginity, but the gain in confidence more than compensates. I literally look brighter.
Whereas only surgery will fix seriously overhanging brows and ptosis, “soft option” procedures that temporarily rejuvenate the eye zone are rapidly proliferating. As age markers, eyes are the first to go: according to a 2016 study presented by Olay to the American Academy of Dermatology, the eye area can have a biological age of up to 22 years more than one’s chronological age. Skin here is constantly moving so it wrinkles easily, and poor circulation makes it prone to both fluid retention and dehydration. Because it’s the thinnest in the entire body, when weak blood vessels leak below the surface, the blood shows through as bluish circles. Age-related loss of bone and fat pads that keep youthful brows lifted and gaunt shadows at bay are also a major factor. In his role as medical director of the New York Dermatology Group at Harrods’ Wellness Clinic, Dr Papageorgiou addresses this with the NYDG E-Lift (£1,000), using hyaluronic acid injections to replump and wake up sleepy hollows within a mere 15 minutes. Effects last for a year to 18 months and can enhance or even delay surgery, he says.
“The eye area is crucial to how well you look,” comments Dr Stefanie Williams, founder of Eudelo. “Treatments today are less about correcting lines and wrinkles and more about not looking tired.” Her Eudelo Triple Eye Lift (from £2,995) addresses crepey skin and mild to moderate brow sag with Ultherapy (high-intensity ultrasound) and Plasmage (a device that uses ionised gas to create tiny electrical arcs that “dot” the skin’s surface). The lift is performed over two to three sessions and the combination of treatments stimulates collagen, the skin’s firming protein, and helps to tighten skin. Results peak at around three months and can last for two or three years. “Plasmage could prove an alternative to surgery, but don’t leave it too long,” Williams advises. Prevention and early intervention are key – the prime time to act is when you first notice your lids are lax, she says. Meanwhile, skincare – the third phase of her triple treatment – is essential home maintenance.
Glow Rehab (from £2,200) is another combination treatment developed by oculoplastic surgeon and aesthetic doctor Dr Maryam Zamani. PRP Micro Needling (the site-specific “Vampire” treatment, where the patient’s own blood platelets, rich in growth factors, are isolated and reinjected) helps with skin texture; a non-ablative Genesis laser stimulates collagen to plump skin; and Profhilo hyaluronic acid also boosts collagen and leaves skin refreshed and glowing. “I devised Glow Rehab for those who aren’t opposed to intervention, but simply want to try something minimally invasive first. You can pretty much leave my office and go about your normal life after each session,” says Zamani.
To lighten deep pigmentation and “panda eyes”, Dr Sabrina Shah-Desai dispenses an average of three sessions of Tixel RRS-Meso (from £750). Tiny titanium waffle rods, heated to 400ºC, are fleetingly placed under the eyes to create channels that will boost collagen and absorb a skin-brightening serum. Expect a couple of hours of soreness and light scabbing for around a week, but this controlled heat treatment creates less inflammation than lasers and can firm and lighten skin by up to 60 per cent, says Shah-Desai. With dedicated use of sunscreen, results can last for a year or two.
All the doctors I spoke to stressed the importance of skincare to prepare skin pre-procedure, improve recovery, help extend results and protect skin from further damage. Dr Williams advocates creams containing retinol to tackle crow’s feet, sagging and wrinkles. “If you can tolerate your regular retinol cream, take it as far as you can without getting it in your eyes. Go easy on lids, where skin-on-skin contact in creases and folds will increase penetration and potency. Stop if there’s redness or dryness,” she counsels. To avoid inflammation, retinol eye creams are typically mild. IS Clinical Youth Eye Complex (£82) contains buffered retinyl palmitate, plus growth factors, peptides and hyaluronic acid to help tackle lines, dryness and puffiness and prep skin prior to surgical procedures.
As retinol encourages exfoliation it leaves skin more vulnerable to UV damage, so creams are best worn overnight and replaced by an SPF30+ during daylight. Dr Zamani’s MZ Skin Depuff & Define Contouring Eye Rescue (£90) has only a minute amount of retinol, so that dry, sensitive eyes can use it to combat puffiness and dark circles. “Creams are no substitute for surgery, but keeping delicate skin hydrated is vital for youthful-looking eyes,” she says. Beverly Hills doctor Harold Lancer’s eponymous Legacy Eye Treatment Duo (£380) consists of a brightening day gel-cream with film-forming polymers that lift, while light-reflecting pigments and collagen-boosting micro-algae help to firm long term. The richer night cream has omega fatty acids, firming growth factors and anti-inflammatory white truffle extract. Both are dispensed by titanium roller balls, which encourage lymphatic drainage and so help to reduce puffiness.
If an emergency eye-opener is required, patches are trending. Inspired by mesotherapy needling that micro-punctures the epidermis so that skin-boosting solutions penetrate deeply, Radara Eye Patches (£165 each) contain 3,000 tiny medical-grade polymer needles that encourage hyaluronic acid to sink in. A painless, albeit tingly, five-minute session leaves eye bags suitably taut: Radara claims a 35 per cent wrinkle reduction after this 28-day course. Alternatively, Vichy Liftactiv Micro Hyalu Patches (£21.40 per pair) can be worn overnight, making them ideal in-flight prophylactics against red-eyed puffiness.
Personally, I find both Emma Hardie Midas Touch Revitalising Eye Serum (£49) and Natura Bissé Diamond Extreme Eye Cream (£171) soothing, especially at night. During the day, I prefer light gel-serums that won’t creep into my eyes and onto my lenses – Perricone MD Cold Plasma Eye (£80) and NYDG Re-Contour Eye Gel (£17) create a cool, firming film that is a good base for concealer – that trusty instant wake-up call that banishes redness and fatigue, post-op or not.
“Distrust very creamy concealers that settle into creases,” warns make-up artist Sara Raeburn. “The ideal is flexible enough to blend without dragging skin, yet firm enough to settle and last.” Zelens Active Concealer (£37) hid my post-surgical black eye; Raeburn also likes Rodial Airbrush Concealer (£32), finger-pressing it into the tear trough and either side of the nose with a light, rolling action. The merest dusting of featherlight, colourless Jurlique Rose Silk Finishing Powder (£26) prevents creasing without highlighting wrinkles. Not a sore eye in sight.