Eyes Wide Open

What can you do when skincare and makeup are no longer a fix for tired-looking eyes?

So off to the dermatology offices of Dr Patricia Wexler I go. Wexler’s solution is similar to what Marmur had recommended: start by injecting filler in the hollow at the temple, which serves, architecturally, as an anchor for the face, and everything will be correspondingly lifted up along with it. Lifting the upper margin of the cheek a millimeter or so (more filler) will help restore the “infra-orbital groove,” helping to mask the eye issue and provide what Wexler calls “scaffolding” in the area. Wexler also suggests a series of treatments with her latest obsession, a tissue-tightening radiofrequency device called Thermi-Smooth.

“It’s fabulous. Everybody loves it,” enthuses Wexler. “When you give heat greater than 40 degrees but less than 45 degrees, you are contracting collagen. It’s like putting shrink-wrap—or Spanx—over the eye pads. The heat also stimulates fibrogenesis, the creation of new collagen. You can literally see the improvement over several months as the area gets tighter.”

With that, she whips out her iPhone and starts scrolling through pictures. “You’re going to be impressed. Here, recognize her?” she says, displaying before-and-after snapshots of a famous 1980s supermodel. “This is only Therm,” she continues, pointing to visible improvements in the hooding of the eyelid, brow elevation, under-eye bags, and forehead lines. “The texture—look at the difference!” She got a cosmetics contract after this.”

My non-surgical dabbling begins with filler. Wexler has chosen Restylane for me, a robust, hyaluronic acid-based injectable that, placed under the muscle, also has the capacity to lift. I have a three-year-old’s pain threshold and even après numbing cream, I am gritting my teeth and squeezing little rubber balls in both hands with white knuckles as Wexler plunges the needle into my face again and again (and again). After the first side is complete, she stands back to inspect her work. “That’s a lot of change in five minutes,” she marvels. In addition to subtle improvements in the temple and cheek (and thus, lower eye), “it raises the jawline, the corner of your lip, even your brow. This nasolabial fold is miniscule compared to the other side. Look at that! Yay!” I look for myself in the hand mirror and am reminded of a car that has been left dented on only one side. It works!

Later that week I go in for my first Thermi session with Wexler’s resident pro, dermatologist Dr Shereene Idriss. Idriss attaches an adhesive silver grounding pad to my back (“or else you’ll get electrocuted”) and starts rhythmically moving a wand back and forth over my upper and lower lids while I lie on my back. “You’ll feel the heat slowly building up,” she says. “It’s very relaxing; patient’s actually fall asleep. It’s the only enjoyable thing we do here.” Indeed, the heated wand feels like hot wax—imagine a paraffin pedicure for the face. It’s a series of four to eight weekly treatments (a significant investment of both time and money); in terms of seeing results, “Three is usually the magic number, “ says Idriss. And by week three, Idriss, whom I now call Shereene, tells me I look markedly better. Where? “Everywhere. The texture and quality of the skin looks tighter and brighter. Your eyes look more open.” She flips to a mug shot in her phone of a glum, dejected-looking person (me), and holds it up for proof while I gaze at my new and improved self in the mirror. “There’s more space between the lid margin and the fold,” she says. (True.) “Look how heavy it was, drooping down,” she continues, not one to mince words. As for the eye-bag-masking supermodel Spanx effect, I am still waiting for that. But now, after four Thermi sessions, the skin around my eyes does feel slightly more taut. The Botox Idriss gave me has wiped away the beginnings of crow’s feet and has smoothed out the top quadrant of my face, which adds even more lift.

I still crinkle a bit under the eyes when I smile (smiling is a good thing), but those lines can be addressed by more non-surgical dabbling. All of the doctors I spoke to ardently recommend deep glycolic acid peels (which exfoliate over the course of a week) around the eyes for texture refinement. “Every time I do a TCA peel I remember how great they are,” enthuses Wexler, who flips automatically to a picture of one of Manhattan’s most impeccable doyennes—a longtime patient—who is inexplicably in her upper seventies. “You don’t have to look old,” she  says matter-of-factly.

Eight weeks after my eye intervention, I find myself cautiously approaching the mirror, fraught with terror that the Restylane and Botox will soon wear off. I will deflate and all will be lost. That’s the caveat of these miraculous, non-invasive procedures: they only last so long (four to six months for Botox; three to four months for hyaluronic fillers). Sooner or later you are back to Cinderella, pre-ball. My needle will eventually turn into a pumpkin.

I see Dr Idriss at a breakfast event and she tells me to wait a few weeks, then come in for a tune-up. She may even add a few “micro-droplets” of Belotero, a lightweight hyaluronic injectable that’s ideal for shallow areas like the tricky-under eye. Because it’s less dense than other products, Belotero does not risk the dreaded Tyndall effect (when the under-eye appears bluish as the result of filler not being placed deeply enough beneath thin skin). “It disperses evenly; it doesn’t clump,” she explains. The idea is to “soften the ledge” further, for a more uniform contour. “Is it going to mask the bag’s completely? No. But this is a good option.”

Source: Porter. Summer, 2016.