The eye area is one of the first to show signs of aging. The skin around the eyes is especially thin and delicate, with fewer sebaceous glands and a looser dermal structure, making it more vulnerable to loss of firmness, the appearance of wrinkles, dark circles, and puffiness.
Nowadays, eye rejuvenation has become an increasingly common request in aesthetic medicine clinics, but isolated approaches are rarely sufficient to address the complexity of this area. That’s why combined treatments offer a more effective and personalized solution.
Treatments for eye rejuvenation
Periocular aging is multifactorial: it involves loss of collagen and elastin, impaired vascularization, uneven pigmentation, fluid or fat accumulation, and eyelid laxity. Each sign requires a different approach. While dynamic wrinkles respond best to botulinum toxin, dark circles may require a dermal filler, and sagging skin needs deep collagen stimulation.
Combining treatments allows for a comprehensive approach to these factors, enhancing results and improving patient satisfaction.
Botulinum toxin (Botox)
Indicated for dynamic wrinkles such as crow’s feet, eyebrow lift, or opening up the gaze. Its muscle-relaxing effect helps soften expressions without losing naturalness. It is ideal as a first step to prepare the area and reduce the contraction force that contributes to dermal wear.
- Advantages: visible effect in 3-5 days, safe, controllable results.
- Limitation: does not act on static wrinkles or pigmentation.
Dermal fillers
Especially useful for the tear trough, hollowing of dark circles, and volume loss in the mid-cheek area. The choice of cross-linking and injection technique is key: it is recommended to use low-density products with a high safety profile and deep placement, avoiding excess product.
- Advantages: immediate results, improved hydration, “rested” effect.
- Limitation: risk of persistent swelling if the area is not properly evaluated or the patient is not a suitable candidate.
Radiofrequency
Techniques that induce collagen production in the middle and deep dermis. Radiofrequency is one of the most promising methods to treat mild to moderate laxity of the lower eyelid and static periocular wrinkles. It can be used in patients with early laxity or as maintenance treatment after fillers or botulinum toxin.
- Advantages: progressive improvement, non-surgical tightening, minimal downtime.
- Limitation: requires multiple sessions, does not remove significant excess skin or fat.
Transdermal electroporation
Non-invasive technique that uses high-frequency electrical pulses to increase cell membrane permeability, allowing the penetration of active ingredients without needles. In the eye contour, it is used to deliver draining agents (such as caffeine or escin), depigmenting agents (tranexamic acid, vitamin C), and firming agents (peptides, organic silicon).
For example, at Sisneo we work with the product Eye Care, specially designed for the eye contour, composed of active ingredients that enhance eye rejuvenation.
- Advantages: visible improvement in hydration, texture, and tone; safe and well-tolerated treatment; needle-free and no downtime.
- Limitation: requires multiple sessions to consolidate results; its effect depends on the quality and concentration of the active ingredients applied.
Gentle peels
Treatments that even out skin tone and improve the texture of the periocular skin. Mild acids (mandelic, lactic, tranexamic) or light-based technologies such as non-ablative fractional laser or IPL are used to reduce pigmentation, increase brightness, and improve skin microrelief.
- Advantages: visible results from the first session, improvement in pigmentation.
- Limitation: not suitable for all skin types, risk of post-inflammatory hyperpigmentation if not properly managed.
How to design an effective combined protocol
The success of the treatment lies in an accurate diagnosis and a stepwise plan. A proposal may include:
- Phase 1: Botulinum toxin (day 0)
- Phase 2: Tear trough or dark circle filler (day 15)
- Phase 3: Fractional radiofrequency (day 30 and monthly sessions as needed)
- Phase 4: Transdermal electroporation (1-2 times per week, combined with other techniques or as a standalone treatment)
- Phase 5: Gentle peels or resurfacing to complete improvements in texture and pigmentation
The combination should be adapted to the patient’s age, anatomy, expectations, and tolerance to downtime. Clear communication and follow-up clinical photographs are key to assessing progress.
Finally, it is essential to always evaluate ocular function before any treatment, especially when working near the eyelid margin. Avoid over-treating, as naturalness is the new luxury. Not all patients require every technique; knowing when to say no is also part of professionalism.
