Unpacking the Undereyes

By Warren B. Seiler III MD

Over the course of my career, one of the most common areas of concern patients have come to me about is the undereye. The skin under and around our eyes is fairly thin, and oftentimes goes overlooked within one’s skincare regimen. The types of issues patients bring up with me vary from case to case, but some of the more typical ones include:

  • Fine lines and wrinkles
  • Dark circles
  • Drooping
  • Volume loss
  • Prominent veins
  • Puffiness

The undereyes are not only one of the most common areas of concern among patients, but also are one of the most frequently misunderstood and mistreated areas of the face. Many practitioners believe that filler is the one-size-fits-all solution for treating the undereyes, but this simply isn’t true. Vascular and pigmentation issues cannot be resolved with filler alone and, in some cases, injections can actually exaggerate symptoms such as puffiness around the eyes.

I take a more holistic approach when addressing the undereyes to ensure patients receive the care and treatment needed to resolve their issues – not exacerbate them. I begin every one-on-one consultation by conducting a full assessment of the under-eye area to pinpoint a patient’s concerns. Through this process, we look for issues such as discoloration, skin laxity, volume loss, prominent veins and even puffiness from fluid/allergies. After consulting with the patient and establishing realistic expectations with them, I then develop a treatment plan specific to their concerns and needs. Some issues may be addressed with injectables or laser treatments, while others may require a more aggressive, surgical procedure. The consultation process is integral to making sure every patient’s best interests are kept in mind and that everyone is on the same page regarding intended next steps.   

One treatment proven to be incredibly effective for addressing under-eye concerns that I’ve administered for years now – and on which I was invited to lecture at this year’s annual Aesthetic Show in Las Vegas – is PRP. As mentioned previously, filler is great for treating some under-eye issues, but not all of them. PRP, short for platelet rich plasma, is a concentrated source of platelets, growth factors, and cytokines that stimulate and control healthy regenerative processes in the body. By injecting PRP prior to filler, I’m able to treat issues such as volume loss, uneven texture, discoloration due to hollowing, and skin laxity. This solution is so transformative that some patients don’t even require filler injections post-PRP!

Take a look at some of the amazing before and after photos of patients who have undergone PRP treatments at our practice.