Sonul Mehta, MD
Scheie Vision Annual Report 2021
Sonul Mehta, MD is an oculoplastic surgeon in the Department of Ophthalmology and Director of the Oculoplastic Surgery Service. She specializes in cosmetic and reconstructive surgery around the eyes, and has a special interest in aging-related changes of the eyes and midface, skin cancers of the eyelids, and inflammatory conditions of the eyelids.
Rejuvenation of the Eyes: Post-COVID Glow-Up
In this Q&A, Dr. Mehta discusses what to consider for periocular rejuvenation this winter and a post-COVID glow-up. It has been an exhausting and stressful two years with the pandemic and the lockdown, and now with masks, there is greater focus on the eyes. Below, Dr. Mehta describes what patients can do to help refresh and rejuvenate their eyes.
Q: The dreaded under-eye dark circles…what causes them?
Dr. Mehta: There are a number of reasons why you can have dark circles around the eyes. Two main causes are hyperpigmentation of the skin and fat prolapse (bags under the eyes) as we get older. We start to see the shadowing of blood vessels of the fat pads under the thinning periocular skin.
Q: What can patients do to treat this hyperpigmentation?
Dr. Mehta: A proper evaluation is essential to determine the cause of the hyperpigmentation. There are a number of reasons why we can get periocular hyperpigmentation. Two common causes of hyperpigmentation of the facial skin are melasma and post-inflammatory hyperpigmentation (PIH). Melasma is characterized by patchy pigmentation of the skin that can be caused by genetics or aggravated by factors such as UV exposure and hormones. PIH is hyperpigmentation that results from inflammation or trauma to the skin. Prevention is key. Topical sunscreen, even in the winter months, is a must. There are other topical agents, including serums, antioxidants, and creams, that can be added to your skincare routine to prevent worsening and reverse hyperpigmentation depending on the cause. Which agent or combination of agents is best to use depends on the patient’s skin type and the cause of the hyperpigmentation. There are lasers that can be used to help with this as well.
Q: What treatments are available for “saggy” or “droopy” eyelids?
Dr. Mehta: There are multiple causes of droopy, saggy, or baggy eyelids. The first step to treatment is to determine the cause of the droop—is it an eyelid muscle issue, fat prolapse, excess eyelid skin, or droopy eyebrows causing the saggy eyelid? Oftentimes, we have to do surgery to either tighten the muscle in the eyelid, called a ptosis repair, or do a blepharoplasty to remove the excess skin and fat that has come forward in the upper or lower eyelids as we age. This can make someone appear less tired and more refreshed, and can decrease the shadowing of the blood vessels, thereby improving the dark circles.
Q: Do you offer non-surgical treatments for this?
Dr. Mehta: Yes, botox and fillers can also be used around the eyes for periocular rejuvenation to help improve wrinkles and hollowing, and to lift the brows.
Q: What are some takeaway points for our readers?
Dr. Mehta: A comprehensive and thorough evaluation of the eyes, skin, and structures of the eyelids is an important first step in refreshing the appearance of your eyes. The eyes, eyelids, and eyebrows are an intricate and dynamic area balancing function, aesthetics, and expression. Secondly, every patient is different. For some, a topical skincare regimen is needed, while others may need non-surgical treatments such as botox, fillers, or lasers. And for others, surgical treatments are necessary, or a combination of the above is suggested. It is essential to examine and review a patient’s skin type, eye health, and structural changes, and to understand what the goals of treatment are, in order to determine the best personalized management for a patient’s periocular aging changes, without compromising function or facial expression. It is a blend between art and science, with the mission of helping others function and feel better about themselves, which is why I love what I do!