An Oculoplastic Surgeon Says People in Their Mid-Twenties Are Requesting Eyelid Surgery Now More Than Ever

Interest in cosmetic eye procedures has grown significantly since March of 2020: According to the American Society of Plastic Surgeons, it was the second most-popular procedure last year, thanks to more time spent at home and what doctors and patients deem as the “Zoom” Boom.” Even as the year ends, Woodbury, NY oculoplastic surgeon David A. Schlessinger, MD says his patient count is still on the rise, but with a tiny tweak: The demographic is now trending younger and younger, with the average age shifting from the early forties down to the mid-twenties.

Has demand for eyelid surgery gone up since the pandemic started?

“In general, demand for eyelid surgery has gone up since the pandemic, mainly because everyone is working from home and staring at their cameras more. What’s most interesting is that the average age for eyelid surgery is getting younger. Regarding the lower lids, patients are now concerned about puffiness, bags, dark circles and things that make them look less alert and more tired. For the upper eyelids, patients are wanting to fix the hooded look.”

What procedure are patients most interested in?

“When it came to performing cosmetic eyelid surgery 20 or 30 years ago, the general goal was to try to take out as much skin and fat as possible. Although that technique will successfully get rid of the bags and the hooded look, it can make you look older, and the demand is now for a more youthful look. When I do upper eyelid surgery, we’re doing more fat-preserving surgeries where we’re not removing a lot of fat. This mostly entails skin removal and very little fat removal, and sometimes we’re transferring some of the fat from a full area to a hollower area to give it a more even contour. For lower eyelid surgery, we’re also trying to avoid that hollow look underneath the eyelids, so we’re doing less-invasive surgery with minimal fat removal. This can eliminate that ‘bulge,’ yet still give a smoother look, minus any hollow.”

Are you doing more upper or lower eyelid surgery?

“We’re doing a lot of both. I think it’s accurate to say that lower-only is more common in younger people and upper and lower is more common in older people—mainly because a lot of the bags underneath the eyes can be congenital in nature and are not necessarily a sign of aging .”

What is the most popular eye surgery since COVID hit?

“The actual surgical requests are not different, but they are becoming more common. Most frequently, I have younger people coming in for lower lid surgery; I also have more men coming in for business purposes. When you’re on Zoom, you start noticing these aging changes and people are now figuring out that there’s something they can do about it. Another big trend we’re seeing is that more patients are getting surgical procedures done because they have the option of recovering at home—they aren’t required to attend social events and live meetings like they were when they were working in the office.”

Are injectables for the under-eye are also on the rise at your practice?

“My injectable business has gotten much busier. I do a lot of lower and upper eyelid fillers, in general, but it’s important to note that the younger demographic is usually better suited for lower eyelid filler than the older patient. I use a cannula when I fill the lower eyelids, so, typically, there’s much less swelling and bruising. Patients can have lower lid fillers done and all they have to do is apply some concealer and get back to work within a day.”

Are there any new technologies for eye aesthetics you’ve been especially impressed by?

“We’ve recently incorporated FaceTite and Morpheus into the practice, so I’m doing a lot of Morpheus microneedling and radiofrequency treatments for candidates who need face tightening. I have a lot of patients who would only be able to get rid of their excess skin through surgery before, and now we’re able to do it with Morpheus or laser. The advantage of Morpheus treatments is that there’s only about a day of downtime and the improvements are dramatic. It takes up to a year to see the final result, but you continue to improve for that year—so it’s been a mainstay. I’m doing three to five Morpheus treatments every day. I might need another machine to keep up with the demand!

For younger people who want to have a brighter look to their eyes, I’ve been combining neurotoxin injections with Ultherapy. I use Botox Cosmetic in the crow’s feet and glabella area to open the eyes and I combine that with Ulthera to give a little tightening. That raises the brow and can tighten the lower lids a bit. It’s not as robust of an improvement to the skin as Morpheus, but it does give a lift. We’re doing a lot more with the brows both surgically and non-surgically—especially for the older patient. We’ll do a brow lift with upper eyelid surgery, or we can do a minimally-invasive endoscopic brow lift.”

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