Look rejuvenation without surgery - Dr Benouaiche

How to get a younger look?

An old saying goes that the eyes are the mirror of the soul.
When someone is asked what they notice first about a person they meet for the first time, it is often the eyes or rather what those eyes convey, the gaze.
A gentle gaze, a lively gaze, a joyful gaze, a sad gaze, an angry gaze.

Emotions are conveyed through look, eyes are a communication vector.Sometimes, we understand each other with just a simple look, without even speaking.

When our eyes are swollen with bags or marked with wrinkles, all we perceive is a tired or sad appearance!

Why do we have dark circles, crow’s feet, or hollow temples?

The eye area is referred to as the upper third. It includes the forehead, temples, nose wings and under eye bags.

In aesthetic medicine, we treat the entire whole area rather than just parts of it. The goal is to rejuvenate a tired appearance, creating a serene and refreshed look in a very natural way.

The orbital area is the most fragile part of the face. Its skin is very thin and prone to wrinkling.

Dark circles are a highly mobile and engaged area, constantly in use when we smile or cry or squint… As we age, our daily 15,000 blinks weaken the supporting fibers, which causes the skin to loosen and appear more wrinkled, resulting in the formation of crow’s feet.

Aesthetic medicine and surgery offer quite some solutions to enhance the eye area.

Different types of dark rings

Under-eye circles are a common reason for consultation. They can often be constitutional and even present in adolescents. As we age, changes of the bone structure, muscles, skin, as well as fat loss under the eyes may create or accentuate under-eyes circles.

Hyaluronic acid will only correct hollow under-eye circles.

Colored under-eye circles can be classified into two types:

  • Dark brown circles that are hereditary and caused by pigment accumulation.
  • Red or blue circles, resulting from the visibility of capillary vessels in the dermis that appear through extremely thin skin. These can be hereditary or age-related.

Hyaluronic acid won’t be an appropriate treatment for colored under-eye circles.

Hyaluronic acid for enhancing the eyes?

Wrinkles around the eyes, hollow under-eye circles, and a sunken orbital area… As we age, the face develops lines and depressions, giving the patient a tired or sad appearance.

Hyaluronic acid injections will help filling hollow under-eye circles, but also the area called the “tear through” (a line starting from the inner corner of the eye to the nose). It is not uncommon for your aesthetic practitioner to suggest restoring the temples, an often overlooked area of the face that also experiences volume loss. Treating the temples can open up the eyes by lifting the brow tail, providing a fresher and less sad appearance to the eyes.

Tear through. A few minutes after the treatment.
Correction of a sad look (under-eye circles).

Reminder about hyaluronic acid

Hyaluronic acid is a molecule naturally found in the skin. It fills in the gaps between epidermis cells. Hyaluronic acid maintains the firmness and elasticity of the skin, giving the face a plump appearance.

From the cheek to tear through…

Dr. Benouaiche: “Before filling in the under-eye circle, I use the MD Codes method to restructure the orbital framework, starting at the cheek, and then the tear through.

The tear through starts at the inner corner of the eye and descends to the base of the nose. We inject the hyaluronic acid in the mid-face region. By lifting the tissues, we achieve a naturally relaxed look, making the expression fresher and rejuvenated. The under-eye circle is filled, and the hollow under the eye disappears for a duration of 24 months.

For the temples, temporal fat tends to disappear, temples hollow out. They give a closed effect to the look and lower the eyebrow tail. Hyaluronic acid is injected in the temporal cavity for a duration of at least 2 years.

Treatment of under-eye circles with injections using the “MD Codes” technique.

Medical advice before and after hyaluronic acid injection treatment


Patients with autoimmune diseases, pregnant women and breastfeeding mothers can’t undergo this kind of procedure.

A few advice before the treatment

It is advised to avoid bruise-inducing factors like aspirin, anti-inflammatory drugs or anticoagulants.

Some advice after the treatment

The post-treatment effects are simple: redness that disappears within 1 to 2 hours, and bruising that may appear and gradually fade over a few days. These discomforts can be concealed with makeup starting from the day after the injection. It is advised to avoid strong sources of heat (sauna, steam room), extreme cold, and vigorous physical activity within 24 hours after the treatment.

Is botulinum toxin, Botox®, a first choice for enhancing the eyes?

Botox helps relax the muscles. The forehead muscles and around the eyes are highly active and prone to movement. They create wrinkles that, initially, relax but eventually leave traces even at rest. Botox is the solution for smoothing the features and giving a refreshed appearance to the upper third of the face.

Result at rest after one session with Vistabel.
Result at rest after one session a year with Vistabel for 3 year
Treatment of the crow’s feet lines of a 40-year-old woman.
The same person, left side.

Indications for Botox

Botox is highly indicated to smooth the forehead wrinkles, eliminating crow’s feet (wrinkles around the eyes), and softening the glabellar lines (frown lines). Botox can open up the eyes and give them a refreshed appearance.


Which technique is most suitable?

Opening up the eyes: before and after a combination of MD Codes and Botox

I often explain that the role of a surgeon is to guide patients towards the best option based on their needs. Here, I present the case of one of my lovely patients who came to the clinic for the placement of tensor threads to open up her eyes.

During the consultation, I realized that another technique would be more suitable to meet her request. To achieve this, I combined two aesthetic medicine techniques:

  • The MD Codes technique to correct facial volume in the temple area.
  • Botox injections to lift the brow tail, which rejuvenates and refreshes the eyes.

By combining these two techniques, the patient was able to achieve the desired result and meet her expectations, all without the use of tensor threads.
I would like to emphasize the importance of taking the time to discuss with a practitioner before undergoing any type of aesthetic medicine or surgery procedure, so that they can guide you towards the most suitable solution.

Do you have two vertical lines between your eyebrows?

Your doctor will suggest to relax these lion’s wrinkles that give you a strict look. Botulinum toxin is injected into the muscle located above the brow, on each side. After about 10 days, the result is optimal and final. Similarly, the horizontal frown line can also be corrected with Botox.

Do you have fine lines around your eyes?

These are commonly known as crow’s feet. In this area, your doctor will prefer using botulinum toxin injections. Three points will be injected into the orbicularis muscle at the outer corner of each eye.

Are you experiencing sagging brows?

Your doctor can lift the tail of your brow to address this concern, as sagging brows can give a tired appearance. The injection is quick and virtually painless, using a small needle.

Do you have under-eye bags?

When it comes to addressing under-eye bags, whether they are genetically inherited or caused by age and fatigue, botulinum toxin injections are not suitable. Dr. Laurence Benouaiche may suggest a more appropriate surgical procedure or, if possible, a treatment using hyaluronic acid injections.

For the surgical removal of under-eye bags, an evaluation is necessary to determine if fat needs to be excised. Depending on the amount of skin to be removed, a scarless technique can be performed, either through the transconjunctival approach or via the subciliary approach below the eyelashes.

Other techniques to enhance your eyes:

Opening up the eyes with tensor threads:

This surgery-free technique is performed after a local anesthesia. The tensor threads are placed between the tail of the eyebrow and the forehead hairline to open up the expression, as well as to the facial contours to redefine them.

Correcting heavy eyelids with blepharoplasty

Over time, the upper eyelid tends to get heavier. The excess skin that forms on the eyelid weighs down the eyes. This gives the patients a sad and tired look and can become bothersome. They can feel that heavy weight on their eyelids. Dr. Laurence Benouaiche suggests a surgery called blepharoplasty.

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