Contemporary Techniques and Controversies in Nonsurgical Rejuvenation of the Eye

The eyes are a focal point of facial beauty and manifest some of the most telltale signs of facial aging. As more patients are opting to defer or forgo surgical intervention such as blepharoplasty, the derma­tologist has the potential to be at the forefront of periorbital rejuvenation. Periorbital aging involves all layers of the skin, fat, and even the bony orbit, and as such, the periorbital complex presents unique anatomic and aesthetic challenges that must be considered. We review contemporary nonsurgical approaches to rejuvenation of the eye with attention to pertinent anatomy, proper patient selection, variations in technique, and potential complications. Modalities such as neurotoxins, fillers, lasers, radio­frequency (RF) devices, ultrasound technology, chemical peels, and topical therapies are reviewed in the context of periorbital rejuvenation.