• Periocular region rejuvenation is gaining more popularity due to the fact that eye contact occurs in more than 80% of the human interactions hence the periocular area is responsible for many impressions people are getting about people they deal with.

  • No physician should touch a patient with a syringe in his hand before being familiar with the anatomy of the region to be treated.

  • The structure of the orbit and periorbital tissue and skin changes with aging and this is to be considered while working on the periorbital area.

  • Rejuvenation means restoration of the structure and function; this should be the ultimate goal and not only a quick fix or temporary cosmetic improvement with no structural improvement.

  • As long as ageing is a dynamic process, rejuvenation also needs to be dynamic and an ongoing plan.

  • Lopidine (Apraclonidine 0.5%) eye drops (an alpha2 adrenergic agonist, which causes Muller muscles to contract quickly elevating the upper eye lid 1–3 mm) is the only known treatment for upper eye lid ptosis after Botulinum Toxin injection. If it did not work, reassure, it will improve gradually over few months.

  • Malar edema is not uncommon complication of using the fillers in the tear trough area and is most probably due to too superficial injection or too much filler injection and is caused by lymphatic obstruction in an area with poor lymphatic drainage to start with. Dissolving the injected filler might be the best option.

  • Dark circles around the eyes is not caused by hyperpigmentation only. In many cases dark circles are caused by other issues than hyperpigmentation as skin laxity and wrinkles which affect the light reflection as well as veins in the infraorbital area. In addition, systemic causes as anemia, chronic fatigue, insomnia, poor diet, atopy or hormonal disturbances should be explored before initiating any local treatments.

  • Oculoplastic surgery leads to immediate improvement of the skin tone but have minimal impact on the skin structure contrary to energy-based devices and lasers which might need more time and multiple sessions to show the result however it improves the structure of the skin significantly.

  • With the current dynamic life people are demanding no or minimal down time which is an advantage offered by using the injectables which might be the most popular non-surgical aesthetic procedures performed all over the world however more recently people are also became concerned about the natural look which needs experience, talent, proper understanding of the anatomy and physiology as well as being familiar with the different technologies offered by the lasers and energy based devices which can offer good rejuvenation to the skin with minimal down time and very natural look.

  • Combination therapy is always going to be the best. Improving the skin structure and function should be a priority then using materials from outside the body should be the next step if required.

  • If retinol containing skin care products are to be used by the patients, it should be used gradually starting with short application time which should be gradually increased on weekly interval to avoid the skin irritation and peeling. Caution should be taken so that it does not go into the eye when applied in the periocular area.