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Non-Surgical Rejuvenation of the Eyes


Office-Based Treatment of Lower Eyelids with Restylane (15 minute procedure)

Office-Based Treatment of Lower Eyelids and Upper Cheeks with Fat Transfer
(45 minute procedure)

Tired of those hollows, bags, and dark shadows under your eyes? If you are, the good news is there are several very effective and simple office-based procedures available to address this problem area with little to no downtime.

Your eyes are the first thing others see when they look at your face. An immediate impression is formed about your age, energy, and fatigue level. Often you feel well rested and full of energy, but to others you look tired.  Many of patients come in telling me that people comment that they look tired when in fact they are not. This can create a significant negative impression, both socially and professionally.  And when it comes to rejuvenation of the eyes this concern is the most common reason people seek help.  

Understanding the Changes.

As we age, we lose volume in certain parts of our face while we gain volume in other parts. Generally speaking, the region around our eyes and cheeks begins to lose fat, while the jowls and neck begins to gain fat. This progression has little to do with your body weight. The fat volume in the upper cheek and around the eyes are genetically predisposed to volume loss.
When we lose the fat layer along the lower eyelid region and upper cheek, the eyes begin to look hollow.  The outline of the bony rim begins to show. This gives the impression that we‘re fatigued and older. In our practice, this is an important and highly emphasized sign of aging that we treat on a regular basis. Rejuvenation of the eyes is one of the most high impact methods of facial rejuvenation.  

Traditional Eyelid Surgery and Associated Problems.

Traditional approaches focus on blepharoplasty or eyelid surgery in which skin, muscle and fat are removed in order to sculpt the eyes. The reality is many times the eyes would actually look older and often just different as a result. This misses the whole goal of eyelid surgery, which is to make the eyes look refreshed and revitalized.
On a weekly basis we see 2 or 3 patients who feel like their eyes have become hollowed and gaunt looking as a result of fat removal lower eyelid surgery performed years ago.   I  have spent so much time correcting these problems that I now treat eyes in a much more conservative and naturally rejuvenating way.  How is this done?  By adding volume, not removing it.

Rejuvenation of the Eyes- the State-of-the-Art

Adding volume is the most effective way of rejuvenating the eyes. The real advantage is that it is non-surgical and highly effective. My first choice for treating the hollows under the eyes is Restylane or Juvaderm for mild changes in a younger patient (30-40s) This technique is used to fill the tear troughs (cresent-shaped hollows in the corners of the eyes near the nose).
In patients with more advanced volume loss that extends into the upper cheek region, and beyond the tear troughs, fat transfer is an excellent permanent solution. Fat transfer works by restoring the shape and contour of the midface and cheeks. This gives the upper face a much younger appearance without making the person look different. Another advantage of fat transfer is that the results are permanent.  If the patient wants to address the cheeks with an injectable, Radiesse or Sculptra are used in place of fat.  

Of course, every case is unique and an individualized consultation is required to assess what the best strategy is for you.  

See““:[Link Removed] for more before and after examples.


Drkaram, Your links have been removed, please consider upgrading to premium membership.



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Member Comments

    • 0 votes vote up vote up

      Yana Berlin wrote Oct 19, 2008
    • Good to know that at least there is hope as we keep getting older and older.

      Thank you doctor.



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    • 0 votes vote up vote up

      Bobbi Bacha wrote Oct 19, 2008
    • Is it just me or do the first photos have no make up and the second photos do ?  Anyway, how long does each proceedure last, do you have to repeat often or is it permanent and finally, is it safe any side effects.



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    • 0 votes vote up vote up

      Amir Karam wrote Oct 19, 2008
    • The filler (first image) treatment last about 1 year.   The fat transfer (second image) is permanent.  

      Safety with both treatments is very much dependent on who is doing it.  The region around the eye is sensitive both cosmetically and functionally.   So this is one area where you want to make sure the person who is doing it understands the anatomy and does lots of these treatments.  In those cases the risk is minimal and the rewards are high.  In our practice, this is one of the most popular treatments with the some of the highest patient satisfaction rates.  

      Hope that helps.

      Dr. Karam



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    • 0 votes vote up vote up

      Bobbi Bacha wrote Oct 19, 2008
    • thanks Im almost 50 and havent had any proceedures but thought if I got one it may be something to refresh eyes.  I usually see Dr. Obagi in Los Angles when I travel for facials in his facial side and I use his products, but was thinking about eye refreshingin... and I love what you wrote.. thanks so much...



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