The use of periocular fillers in aesthetic medicine

Fat or fillers: The dilemma in eyelid surgery

The aging of the periocular region has always aroused great interest. A fresh, young, and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result. In particular, the change in the concept of a young look, considered then "full", led to the increasing use of surgical (fat grafting) or medical (hyaluronic acid) filling techniques. Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments, with a focus on achieving a youthful and refreshed appearance. Among the various techniques available, the choice between using fat grafting or fillers presented a clinical dilemma. In particular, what surgery considered of fundamental importance was a long-lasting result over time. On the other hand, aesthetic medicine considered it fundamental not to have to resort to invasive treatments. But what was the reality? Was there one path better than the other, and above all, was there a better path for patients? The minireview aims to explore the physiopathology, diagnosis, treatment options, prognosis, and future studies regarding this dilemma. We analyzed the literature produced in the last 20 years comparing the two techniques. Current literature reveals advancements in biomaterials, stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation. The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma. Understanding physiopathology, accurately diagnosing eyelid aging, exploring treatment options, assessing prognosis, and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.

Efficacy Evaluation of a Cosmetic Product for the Periocular Area in Caucasian Women Aged Over 40 Years Old

Purpose

The present study was aimed at evaluating the efficacy of a cosmetic product in improving the appearance of periocular skin.

Patients and Methods

An open-label study on 40 female subjects showing clinical signs of skin aging in the periocular area (including bags under the eye and dark circles) was conducted. At day 0 and day 28 the bags under eye volume, dark circles color, skin texture, skin moisturization, skin elasticity, and skin radiance were measured. The instrumental measurements were integrated by clinical analysis carried out by a board-certified dermatologist and by a self-assessment questionnaire carried out by each subject participating in the study.

Results

After 28 days of product use the volume of the bags under the eye was decreased by 6.8% (p = 0.005), the dark circle color red and blue component improved by 7.1% (p = 0.001) and 4.0% (p = 0.001), respectively, wrinkle depth and skin roughness decreased by 15.8% (p = 0.001) and 6.3% (p = 0.011), respectively, skin moisturization increased by 11.7% (p = 0.000), the skin distensibility decreased by 8.9% (p = 0.000), the overall skin elasticity increased by 10.4% (p = 0.000), and the skin radiance increased by 16.3% (p = 0.000). The instrumental measured effects were also confirmed by the clinical analysis of the dermatologist and the self-assessment questionnaire output.

Conclusion

Conclusions: our results suggest that the test product is effective for periocular skin aesthetics (reduction of imperfections undermining the periocular area) and wellness.

Efficacy and tolerability of a novel skin cream for improving periocular rhytids and dryness

OBJECTIVE

A novel topical cream was developed to address the appearance of aging periorbital skin. The goal of this study was to evaluate the efficacy and tolerability of this product (Total Eye® Firm & Repair Cream; Colorescience, Inc., Carlsbad, CA) for improving periorbital wrinkles, dryness, laxity, and dark circles.

METHODS

This 8-week open-label trial enrolled subjects 35-65 years old seeking periocular rejuvenation (N = 25; 22 female, 3 male). The product was applied each morning and evening after facial cleansing. Study endpoints were changes in Investigator Clinical Grading and Eye Appearance Assessments, Subject Self-assessment Questionnaires, and tolerability after 4 and 8 weeks of treatment.

RESULTS

Among subjects completing the study (n = 23), all (100%) showed some global improvement at Weeks 4 and 8 and almost half (48%) achieved moderate or marked improvement. Improvements were observed for all parameters and were most pronounced for wrinkles, laxity, and dark circles. Improvements for laxity and dryness were significant by Week 4 and for dark circles by Week 8. At Week 8, subjects agreed or strongly agreed that the product made their eyes feel more hydrated (100%), look and feel healthier (95%), and increased confidence in their eye appearance (91%). The product was well-tolerated.

LIMITATIONS

Modest number of subjects and open-label study design.

CONCLUSION

Twice-daily Total Eye® Firm & Repair Cream improved the overall appearance of the periorbital area. The product was well-tolerated and most treated subjects were satisfied with their results. The product is a viable option for treating periorbital wrinkles and laxity and should be considered a safe and effective skincare option.