Lower Eyelid Rejuvenation

There has been a significant advancement in the extremely challenging treatment for the rejuvenation of the lower eyelid using both surgical and nonsurgical procedures to produce the most beautiful and natural-looking results  to each individual. The doctor who developed the breakthrough treatment is Dr. Joseph Shvidler and he is right here in the Pacific Northwest.

Please, read more about Dr. Shvidler’s unique approach to crafting a firmer, more youthful lower eyelid.


by Joseph Shvidler, M.D.

One of the most challenging areas to treat in the cosmetic facial practice are lower eyelid concerns.  I have spent many years thinking, learning and refining the best strategies to achieve reliable and lasting results when it comes to rejuvenating the lower eyelid.

The lower eyelid is a complex structure and it is at a disadvantage when it comes to aging because of several factors. The lower eyelid has to fight the effects of gravity in addition to enduring other aspects of eyelid skin aging, including skin and muscle laxity, skeletonization of the bony rim around the eye, volumetric loss, descent and laxity of the membrane that holds the fatty cushions under the eye (also commonly know as the “eye bags”).

My evaluation starts with listening to my patient’s concerns, than performing a thorough eye exam. I pay close attention to the overall eye structure and how it relates to position of the brow and cheek. If someone has deep-seated eyes, this will create a shadow effect that can further accentuate the dark circles around the eyes. Having studied art techniques in painting classes allows me to hone in on the facial shadows and conceptualize better treatment strategies for the problem areas.

My experiences with both surgical and nonsurgical rejuvenation options have shaped my treatment algorithm when it comes to treating the lower eyelid. Early on, I was dissatisfied with available techniques and since then I have adopted techniques from surgical fat grafting to utilize them with fillers around the eye that produce natural results without lumpiness or filler visibility (the “Tyndall effect”), and reduced bruising. In addition, I am always concerned about safety with treatments around the eye.

Structural fat grafting may be a good option for someone with very deep tear troughs and someone seeking more permanent treatment. Finally, I offer surgical options to patients who feel they would like a more permanent solution or don’t want to have repeated treatments.