The Late Late Aesthetics Show, hosted by Vanessa Lana Brown (owner of VL Aesthetics in Carlisle), delivers expert insights and engaging discussions on all things skincare, aesthetics, and wellbeing.
Video Summary
On this episode of the Late Late Aesthetic Show, the focus turns to the most defining feature of the face: the eyes. As we move forward, a fascinating cultural shift is emerging. Patients are no longer chasing the idea of looking “younger” at any cost. Instead, many simply want to look well-rested, healthy, and at their best — often describing the goal as “looking 35.”
To unpack what that really means, leading London oculoplastic surgeon Dr Elizabeth Hawkes shares her expertise on why the eyes age first, what truly works to rejuvenate them, and how to approach treatments safely and intelligently.
Why the Eyes Age Faster Than the Rest of the Face
The eyes are usually the first area to show signs of aging — and there are anatomical reasons for that.
The Thinnest Skin on the Body
Eyelid skin is among the thinnest skin anywhere on the body. Because of this, it is highly susceptible to:
- Collagen loss
- Fine lines and creasing
- Pigmentation changes
- Laxity
Unlike other areas of the face, there is almost no cushioning fat beneath the upper eyelid skin. Instead, the skin sits directly over the orbicularis oculi muscle — the muscle responsible for blinking.
And we blink approximately 15,000 times per day.
That constant mechanical movement creates cumulative stress over time, accelerating visible aging.
Orbital Fat and Lower Lid Puffiness
The lower eyelid ages differently from the rest of the face.
The eyeball sits inside a bony cavity called the orbit, cushioned by specialized orbital fat. This fat is held in place by a thin membrane known as the septum. With age, the septum weakens and the fat begins to prolapse forward — creating puffiness or “eye bags.”
This process is unique to the eyelid area and does not occur elsewhere in the same way.
The Three Most Common Eye Concerns
Dr Hawkes highlights three primary complaints patients present with:
1. Hooded Upper Eyelids
Patients often report:
- Excess upper eyelid skin
- Makeup smudging
- A heavy or tired appearance
- Visual obstruction in severe cases
The Gold Standard: Upper Blepharoplasty
A surgical upper blepharoplasty remains the definitive treatment for hooded eyelids.
- Procedure time: approximately 45 minutes
- Performed as day-case surgery
- Stitches removed after one week
- Return to normal activity: around 10 days
It is one of the most transformative yet subtle procedures in facial aesthetics. By removing excess skin, the entire face appears more refreshed — without changing identity.
The average surgical patient age for upper lids is around 45.
2. Lower Eyelid Puffiness
Lower lid puffiness is most often due to fat prolapse. Contributing factors can include:
- Genetics
- Allergies
- Fluid retention
- Thyroid dysfunction
Treatment Options
- Surgical lower blepharoplasty (fat reduction or repositioning)
- Non-surgical camouflage treatments
- Skin quality treatments
Modern surgical techniques often use fat repositioning rather than fat removal — redistributing orbital fat into hollow areas (such as the tear trough) instead of discarding it.
The average age for lower lid surgery is around 55.
3. Dark Circles
Dark circles are complex and depend on cause.
If Caused by Pigmentation
Treatment may include:
- Prescription lightening creams
- Laser treatments
- Skin rejuvenation protocols
If Caused by Volume Loss
- Tear trough filler (carefully selected cases only)
- Surgical fat repositioning
If Health-Related
- Iron deficiency
- Chronic fatigue
- Vascular congestion
In many cases, dark circles are multifactorial and require a tailored approach.
The Shift: Looking Well-Rested, Not Younger
One of the most powerful insights from the discussion is this:
The goal is not to look younger.
The goal is to look well-rested and healthy.
Patients rarely articulate it directly, but what they want is to stop being told they look tired.
True rejuvenation restores vitality — not age reversal.
Dr Hawkes often asks patients to bring photographs from their 20s or 30s. This helps determine:
- Whether hooding was always present
- Whether fat pads were naturally prominent
- What constitutes their authentic anatomy
Surgery resets the clock. It does not rewind it.
Non-Surgical Eye Treatments: What Actually Works?
Non-surgical options have expanded significantly in recent years.
Polynucleotides
One of the most transformative additions to eye rejuvenation has been polynucleotide treatments.
These:
- Improve skin quality
- Stimulate regeneration
- Enhance hydration and elasticity
Typical protocol:
- 3–4 sessions
- 3–4 weeks apart
They do not replace surgery, but they significantly improve skin health and can delay surgical intervention.
Ideal for patients in their 30s and 40s.
Tear Trough Filler: Use with Caution
Overfilling the under-eye area is one of the most common aesthetic mistakes.
Repeated yearly filler treatments can:
- Migrate
- Obstruct lymphatic drainage
- Cause chronic puffiness
- Make patients appear older
Filler should only be used where genuine volume loss exists.
It is not a treatment for wrinkles or pigmentation.
Eye Skincare: The Non-Negotiables
Many patients invest heavily in facial skincare but skip eye cream entirely.
This is a mistake.
The Golden Rules
1. Peptide-Based Eye Cream
Peptides act as signaling molecules that stimulate fibroblasts to produce collagen.
Collagen = firmness, hydration, resilience.
Use twice daily.
2. SPF on the Eyelids
The eyelids are a high-risk area for skin cancer because many people avoid applying sunscreen there.
Daily SPF is essential.
3. Sunglasses
Not just for aesthetics — sunglasses protect:
- Eyelid skin
- The retina
- The ocular surface
Even on cloudy days.
Lifestyle and Eye Longevity
Eye health and eye aesthetics are inseparable.
The 20-20-20 Rule
Every 20 minutes:
- Look 20 feet away
- For 20 seconds
This encourages blinking and prevents dry eye.
Nutritional Support
Certain nutrients are known to support retinal health:
- Lutein
- Zeaxanthin
- Vitamin A
- Leafy greens
- Mediterranean-style diet
Smoking significantly accelerates:
- Macular degeneration
- Cataract formation
The Most Serious Risk: Vision Loss from Filler
Although rare (estimated approximately 1 in 100,000), vision loss from dermal filler is the most severe complication in aesthetics.
High-risk areas include:
- Nose
- Glabella (frown lines)
- Temples
- Nasolabial folds
Interestingly, tear trough filler is lower risk than these areas — but still requires expert anatomical knowledge.
Dr Hawkes has contributed to UK consensus guidelines on managing filler-related visual complications, reinforcing the importance of proper medical training and complication management protocols.
The key message: always choose a medically qualified practitioner with deep anatomical expertise.
Rapid-Fire Insights from Dr Hawkes
Upper eyelids or under eyes age faster?
Upper eyelids.
Most natural results: surgical or non-surgical?
Surgical — when performed correctly.
Goal: younger or well-rested?
Well-rested.
Biggest mistake?
Overfilling the tear trough.
Best overall eye rejuvenation?
Upper eyelid blepharoplasty.
Final Thoughts: Resetting the Clock, Not Chasing Youth
Eye rejuvenation is not about erasing age. It is about restoring balance, function, and vitality.
The most successful outcomes combine:
- Intelligent surgery when indicated
- Regenerative treatments
- Consistent skincare
- Healthy lifestyle practices
The eyes define expression, emotion, and identity. When treated with respect for anatomy and restraint in intervention, the results are subtle, natural, and powerful.
The future of aesthetics is not about looking younger.
It is about looking like the best, healthiest version of yourself — at any age.
