5 of the Best Eyelid Rejuvenation Options and their Results

5 of the Best Eyelid Rejuvenation Options and their Results

by Cosmetic Surgeon, Dr. Nerina Wilkinson

Do you wake up after a great night’s sleep and still look tired? Have you ever come back from the most relaxing holiday just for people to ask if you are tired because of the bags under your eyes? The eyes are often referred to as the windows to the soul, but, unfortunately, they can also be the first telltale sign of aging.

Over time, we experience bone, muscle, and fat loss, causing the skin around the eyes to become loose and saggy, and under-eye bags and wrinkles start to appear. The skin around our eyes also lacks sebaceous (oil) glands, and is thinner than on the rest of the body, more contributing factors to the eye area aging faster than the rest of our skin. Fortunately, there are many eyelid rejuvenation treatment options for youthful-looking, bright, open eyes: cosmetic eyelid rejuvenation.

Eyelid rejuvenation procedures are surgical and non-surgical cosmetic procedures that aim to reduce the signs of aging around the eyes, including sagging skin, puffiness, and wrinkles, and there are several types of procedures available. From more intensive surgical solutions and soft surgery, to minimally invasive injectables and non-invasive skincare treatments (for those more focused on brightening and prevention rather than an anti-aging cure).


Eyelid rejuvenation refers to surgical and non-surgical cosmetic procedures that can help to reduce the signs of aging around the eyes and provide a more youthful and refreshed appearance. Whether you opt for a surgical or non-surgical procedure, the benefits of eyelid rejuvenation can be numerous and long-lasting. These benefits include:

1. A more youthful appearance: By reducing sagging skin, puffiness, and wrinkles around the eyes, eyelid rejuvenation can provide a more youthful and refreshed appearance.

2. Improved confidence: When you look better, you feel better, therefore eyelid rejuvenation procedures can help to boost your confidence and self-esteem.

3. Enhanced functionality: In some cases, excess skin around the upper eyelids can impair vision. Eyelid rejuvenation can help to improve vision by removing this excess skin.


There are many eyelid rejuvenation procedures available today. From the treatment of undereye hollows and brightening dark circles, to the smoothing of periorbital wrinkles and the removal of excess eyelid skin. Today we will cover 5 of the best eyelid rejuvenation options and their results.

1. Eyelid surgery: Upper and lower blepharoplasty

My top surgical approach to eyelid rejuvenation is called the EYELight360™ Blepharoplasty procedure. This is a comprehensive approach to surgical eyelid rejuvenation that involves addressing all aspects of the aging eyelid skin, including the upper and lower eyelids, as well as the surrounding tissues, muscles, and ligaments.

This signature 360-degree approach is designed to achieve a more natural-looking and long-lasting result by considering the entire structure of the eye area, rather than just focusing on isolated concerns (such as only removing the excess upper eyelid skin). The procedure includes a combination of surgical approaches such as eyelid surgery, laser skin resurfacing, and lipofilling to help to ensure that the eyes are rejuvenated in a balanced and harmonious way, without creating an unnatural or “overdone” and skeletonised appearance.

If you’re considering a more advanced approach to eyelid rejuvenation, the comprehensive approach of the EYELight360™ Blepharoplasty might be the perfect solution for you.

Upper eyelid surgery (blepharoplasty)

Upper eyelid surgery alone can, however, have a dramatic impact on the appearance of the eyes and can even make the eyes appear larger and more alert. Many patients report feeling more confident and attractive after undergoing upper eyelid surgery. Known as upper blepharoplasty, this surgical procedure removes excess skin, fat, and muscle from the upper eyelid area. But how does upper eyelid surgery specifically rejuvenate the upper eyelids? Let’s take a closer look.

1. Removes excess skin: One of the primary reasons for sagging and droopy upper eyelids is excess skin. Upper eyelid surgery involves removing this excess skin to create a smoother and more youthful appearance. I make a small incision in the natural crease of the upper eyelid, which helps to conceal the scar.

2. Reduces puffiness: In some cases, the upper eyelids can appear puffy due to the accumulation of fat. Upper eyelid surgery can remove this excess fat, which can help to create a more defined and attractive eyelid contour.

3. Improves vision: In many cases, sagging upper eyelid skin can impair vision by obstructing the upper field of view. Upper eyelid surgery can help to remove this excess skin. So many patients remark on their improved vision and their overall enhanced quality of life.

4. Enhances self-confidence: Sagging upper eyelids can make you look tired and older than you feel. Upper eyelid surgery can provide a more youthful and refreshed appearance, which can boost your confidence and self-esteem

Upper eyelid surgery is a relatively simple and safe procedure and can be performed on an outpatient basis. Recovery typically takes about one to two weeks, during which time you may experience some swelling, bruising, and discomfort.

Lower eyelid surgery (blepharoplasty)

Lower eyelid surgery, also known as lower blepharoplasty, is a cosmetic procedure that aims to rejuvenate the lower eyelids by addressing issues such as excess skin, puffiness, and dark circles. The procedure results in a more youthful and rested appearance. But how does lower eyelid surgery specifically rejuvenate the lower eyelid?

1. Removes excess skin: One of the primary reasons for the sagging and wrinkling of the lower eyelids is excess skin. Lower eyelid surgery involves removing this excess skin by making a small incision just beneath the lower lash line to access the lower eyelid tissue.

2. Addresses puffiness: Another common concern of the lower eyelids is puffiness or bags. This can occur due to the accumulation of fat beneath the lower eyelids. Lower eyelid surgery can address this issue by either removing or repositioning the fat. The procedure can create a more defined and attractive eyelid contour.

3. Treats dark circles: Dark circles under the eyes can make you look tired and aged. In some cases, they are caused by a hollowed-out appearance beneath the eyes. Lower eyelid surgery can treat this issue by filling in the hollowed-out area with fat or filler injections.

After a lower blepharoplasty procedure, you may experience some swelling, bruising, and dryness around the eyes in the first few days following surgery. Most patients can return to work and other normal activities within one to two weeks following the procedure, although it’s important to avoid strenuous activity or exercise for several weeks.

Overall, lower eyelid surgery can provide a dramatic transformation if you are seeking to rejuvenate your lower eyelids and achieve a more youthful and rested appearance.

Upper and lower eyelid surgery combination

In some cases, patients may opt for both upper and lower eyelid surgery to rejuvenate the entire eye area. Upper and lower blepharoplasty can provide a more comprehensive and transformative result, addressing both the upper and lower eyelids to create a more youthful and refreshed appearance.

2. Eyelid Fat Grafting

One of the most exciting and innovative techniques for the treatment of hollow and sunken eyes is fat grafting of the eyelids, a surgical procedure designed to fill in hollows and add volume.

What is Fat Grafting of the eyelids?

Fat grafting of the eyelids, also known as fat transfer, is a minimally invasive cosmetic procedure that involves removing fat from one area of the body and injecting it into the eyelid area to add volume and smooth out wrinkles. and hollows to create a more youthful and rested appearance.

How is Eyelid Fat Grafting performed?

This procedure replaces the volume using a 360 approach to create youthful, soft contours that lift and illuminate the periorbital area.

A syringe is used to suction the subcutaneous fat from the donor site (such as the inside of the knees or abdomen). The fat is purified using specialised techniques to create lipografts and nano fat. A multi-plane technique precisely transplants the fat and stem cells to the eye area at different levels and layers to improve facial contours and create an uplifting effect. Our lipofilling procedures also include the introduction of nano fat which is layered very superficially under the skin harnessing the potential of the rich stem cells to improve the quality of the skin.

This can cause excessive swelling in the first 7 to 10 days and then settles quickly. Although most patients only need one procedure as we continue to age and lose volume in the face another session may be required at a later stage.

Are there any risks associated with Eyelid Fat Grafting?

Like any cosmetic procedure, there are risks associated with fat grafting of the eyelids. Potential risks include infection, bleeding, bruising, and asymmetry. However, when performed by an experienced and qualified eyelid surgeon, the risks associated with fat grafting of the eyelids are generally low.

Overall, fat grafting of the eyelids is a revolutionary technique that can provide patients with dramatic improvement in dark circles caused by hollow eyes.

3. Eyelid rejuvenation with cosmetic injectables

For those not ready for surgical eyelid rejuvenation, or for those who don’t quite need a surgical intervention yet, there are some very effective non-surgical eyelid rejuvenation procedures available, also aimed at achieving the most natural-looking results.

Eyelid rejuvenation with filler

One of the most popular and effective non-surgical solutions available today is eyelid rejuvenation with cosmetic fillers, which involves injecting various types of filler into the eyelid area to add volume and smooth out wrinkles. At our practice, we make use of dermal fillers, and bio-stimulating fillers to achieve this.

What are Dermal FIllers?

Dermal fillers are injectable substances that are used to add volume and fullness to the face.  They are typically made of hyaluronic acid, a natural substance that is found in the body and helps to keep the skin hydrated and plump. Dermal fillers can be used to add volume to the upper and lower eyelids, smooth out wrinkles and fine lines, and improve the overall appearance of the eyes.What are Skin Bio-stimulating Fillers?

Skin bio-stimulating fillers are a type of dermal filler that is designed to stimulate the body’s own collagen production. They are typically made of a substance that stimulates the growth of new collagen. Biostimulators can be used to improve the overall texture and tone of the skin and can also be used to fill in wrinkles and fine lines.

Eyelid rejuvenation with Botulinum Toxin injections

Botulinum toxin injections (also known as Neuromodulator treatments) are popular non-surgical treatment options for eyelid rejuvenation! The use of Botulinum Toxin for eyelid rejuvenation involves the injection of the neurotoxin into the muscles surrounding the eyes. This causes those muscles to relax, which can reduce the appearance of wrinkles and fine lines. The bonus is that Botulinum Toxin injections can be used to treat both the upper and lower eyelids.

In the upper eyelids, Botulinum Toxin can be used to address wrinkles and fine lines that are caused by the contraction of the frontalis muscle, which is responsible for raising the eyebrows. By injecting it into this muscle, it can be temporarily paralyzed, which can reduce the appearance of horizontal forehead lines and vertical frown lines between the eyebrows. This can also help to lift the eyebrows and reduce the appearance of hooded eyelids.

In the lower eyelids, Botulinum Toxin can be used to address wrinkles and fine lines that are caused by the contraction of the orbicularis oculi muscle, which encircles the eye. By injecting Botox into this muscle, it can be temporarily weakened, which can reduce the appearance of crow’s feet and other wrinkles around the eyes.

In addition to its cosmetic benefits, Botulinum Toxin can also be used to treat certain medical conditions that affect the eyelids. For example, it can be used to treat blepharospasm, which is a condition in which the eyelids twitch uncontrollably. This treatment can help to relax the muscles that are responsible for this condition, which can provide relief for those who suffer from it.

Overall, Botulinum Toxin injections are a safe and effective treatment option for eyelid rejuvenation when administered by a qualified and experienced medical professional.

4. Radiofrequency and microneedling treatments for eyelid rejuvenation

One of the most common complaints my patients have is crepe eyelid skin that no eye cream has been able to improve. And a lot of these patients are not interested in cosmetic injectables… The most popular non-invasive treatments that improve the quality of this delicate eyelid skin, and that don’t involve injectables, are advanced radiofrequency and microneedling treatments. These treatments work by stimulating collagen production and increasing blood flow to the area, which can help reduce the appearance of wrinkles, fine lines, and sagging skin.

MORPHEUS8 for eyelid rejuvenation

One of the most effective radiofrequency treatments for eyelid rejuvenation is the MORPHEUS8. This is a non-surgical procedure that combines radiofrequency and microneedling to stimulate collagen production and tighten the skin around the eyes.

The treatment is performed using a handheld device that delivers radiofrequency energy through tiny needles that penetrate the skin. This creates micro-injuries in the skin, which trigger the body’s natural healing response and stimulate collagen production.

At our practice, we offer a signature experience to the classic MORPHEUS8 procedure, by including PRP injections for even more advanced results. Using micro-needling radiofrequency combined with platelet-rich plasma injections, the Morpheus Enhance treatment further speeds up cell turnover for an even deeper skin rejuvenation result.

Eyelid rejuvenation with Microneedling

Microneedling treatments are another non-surgical option for effective eyelid rejuvenation. The handheld microneedling device (in our case the Dermapen4) uses tiny needles to create micro-injuries in the skin. This triggers the body’s natural healing response and stimulates collagen production. The treatment is minimally invasive, and patients typically experience little to no downtime, and the results can last for several months.

One of the benefits of radiofrequency and microneedling treatments is that they are non-surgical and minimally invasive. This means that patients can avoid the risks and complications associated with surgery. Additionally, these treatments offer natural-looking results without the need for extensive downtime or recovery.

5. Non-invasive Eyelid Rejuvenation skincare treatments

When it comes to non-invasive eyelid rejuvenation treatments, there is a myriad of effective options. The suitability of these skincare treatments will however depend on the severity and type of concern. Here are two of our favourite eyelid rejuvenation skincare treatments:

If fine lines and wrinkles are the main concern around the eyes, then the Mesoéclat® Bespoke is a great option. This treatment has been designed to activate the skin’s natural healing process which kick-starts the production of collagen and cell regeneration to fight the signs of fatigue and aging around the eyes.

If dullness and uneven skin tone is the main concern, then the Periocular Brightening Peel might be a great fit. This signature combination treatment is specifically designed for clients who want firmer, brighter, and more evenly toned skin around the eye area. This indication-specific combination peel, together with microneedling, forms part of our exclusive periocular protocol for superior results around the eye area.

Final thoughts on eyelid rejuvenation treatment options

In conclusion, eyelid rejuvenation can help you achieve a more youthful and refreshed appearance, and ultimately, the best eyelid rejuvenation option for you will depend on your individual needs and goals.

Whether you choose surgery, injectables, or non-invasive treatments, it’s important to consult with a qualified eyelid rejuvenation expert or eyelid surgeon to determine the most appropriate treatment plan for you. With the right approach and expert guidance, you can regain “that sparkle“ in your eye once more.

Contact us at capetown@drnwilkinson.co.za to request your eyelid rejuvenation consultation.

Written by Dr. Nerina Wilkinson