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Aesthetic medicine and plastic surgery are both an art and a science.  There are multiple concerns and findings to consider in facial rejuvenation, and our facial plastic surgeon, Dr. Inessa Fishman, points to volume restoration as an important treatment in rejuvenating the face.

“The beauty of the human face has a lot to do with the smooth, harmonious transitions between the facial contours,” says Dr. Fishman, “and volume is a key component in maintaining these transitions.”  The face has multiple fat pads that support and volumize the facial structures, and it is important to have these well-volumized fat pads support the brows and eyelids, providing a beautiful frame to the eyes.  “The eyes are the jewels of the face, and excessive shadow or emptiness or sharp outlines to the orbital rim (the bony opening which houses the eyeball)–all these characteristics can take away from the eyes’ expression and their lively sparkle,” says Dr. Fishman.


Eyelid brow fillerWhy does volume loss around the eyes happen?

“Age and genetics make some people much more predisposed to having volume loss around the eyes,” says Dr. Fishman, “and beyond this, illness, certain medications, and some eyelash enhancement serums can contribute to hollow lids or loss of fat around the eyes.”  Youthful lids have a beautiful balance between slight concavity at the inner eyelid and a smooth fulness at the outer lid and fat pad; this youthful fulness is definitely not the same as eyelid bags, relates Dr. Fishman, and its absence can make the eyes and face look harsh, tired, and older.


How does Dr. Fishman approach hollow lids?

Adding volume to the eyelids is an important–but not the only–tool in the aesthetic toolbox.  “I love using dermal fillers or fat grafting to restore tasteful volume to hollow lids,” says Dr. Fishman, “and while sometimes volume is the only thing that is needed, I also sometimes combine volume restoration with skin excision, fat repositioning, laser skin treatments, and brow lifting to rejuvenate the eyes and face.”  Dr. Fishman sculpts volume into overly hollow lids by using hyaluronic acid fillers (such as Restylane and Juvederm) or fat (grafted from the patient’s abdomen, thighs, or flanks).  She commonly uses a cannula, which is a blunt metal tube, to deliver volume to the eyelids, and sometimes supplements the cannula treatment with small needles, to refine the treatment results.

The patient shown is a beautiful example of the importance of volume around the eyes.  She showed a pronounced loss of volume and excessive shadow in her upper eyelids, and Dr. Fishman treated her 2 sessions of dermal filler to restore a youthful, tastefully rejuvenated and full brow fat pad and eyelid.  Not only does this volume restoration make the patient look younger, but it allows her eyes to look more bright and and happy.

Do you want to put your best face forward?  Contact us to schedule your consultation with the expert Aviva team today!

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