The Patient's Question: My deep set eyes are so dark, people think I have smeared mascara under my eyes. As for my wrinkles, my idea of cosmetic surgery has been to stick my tongue into the area of the fold to smooth it out!
I agree about your hollowed out lower eyelids and cheeks. As we age, the face typically undergoes some atrophy -- tissues sag and the fat that gave you plump cheeks goes away. I suggest you re-inflate the cheeks and lips with a fat transfer that takes fat from your tummy or hip and replace the lost fat in your face. Techniques for fat transfer have improved in recent years, and filling the face is now commonplace.
Do not confuse the fillers like Restylane and Juvederm with fat. These off-the-shelf fillers are good for fine lines and wrinkles but will not adequately correct the lost volume under your eyes. My favorite way to replace the volume of your face is with the Viafill Fat Transfer System, which can be administered under local anesthesia. I routinely allow the patient to observe the process with a mirror. A full face fat transfer typically costs $2,500. Downtime from swelling can be from 4-10 days and there are no incisions or stitches.
As for the sun, the most important thing for your skin at this time of year is a good zinc oxide sunblock. My favorite is EltaMD, available in physicians' offices. They have just come out with a spray-on Zinc Oxide. Don't worry about the SPF ratings but be sure to focus on ingredients. Finally, regardless of the time of day or activity level, reapply the sunblock every 2 to 3 hours.
Robert M. Freund, MD, FACS
The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.