Why Eye Wrinkle Treatment Starts with the Muscles: Highlights from the Lumenis EyeLift Symposium

Fine lines around the eyes don't smooth out easily, even with diligent moisturizing.

That's because the muscles and supporting structures around the eyes change along with the skin surface.

That's why I check the condition of the muscles before the skin when I begin eye treatment.

Hello, I am Song Jong-geun, director of Pixel Lab Plastic Surgery Clinic in Sinnonhyeon.

I have spent 15 years as a board-certified plastic surgeon, treating patients throughout that time.

Close-up of the speaker talking into the microphone during his presentation.

The speaker at the podium beside a screen showing the Lumenis device and the symposium title.

On August 8, I was invited as a speaker to the “LUMENIS BeautyTech EyeLift Symposium” held at Grand InterContinental Seoul Parnas. There, I presented the eye rejuvenation approach I currently use in my clinical practice.

Four applicators: Face (contour, lifting), Body (large-area tightening), triFX (microneedling, texture), Eye (eye and delicate areas).

The presentation was titled “The TriLift Eye: Combining Periorbital Muscle Stimulation and RF for Natural Eye Rejuvenation.”

Using the TriLift device, the talk covered how to combine periorbital muscle stimulation with radiofrequency (RF) for natural-looking eye anti-aging.

I often hear this question in the clinic:

“I use eye cream consistently and pay attention to moisturizing, so why does foundation settle into my eye wrinkles by the afternoon?”

This is often followed by another worry: “Will my smile look unnatural if I get Botox around my eyes?”

Based on what I presented at the symposium, today I'd like to explain why I don't see eye wrinkles and aging as simply a matter of skin sagging.

1. Why is anti-aging around the eyes so difficult?

Recently, a growing number of procedures and devices focused on eye wrinkles have emerged, including SERF Eye, Density Eye, Ultherapy Eye, Juvelook, and Ritúo Fine (Re2O). This also reflects growing interest in eye anti-aging.

In practice, however, I've found that no single device or procedure can address every concern around the eyes.

This is because eye aging involves not only surface changes such as skin texture and fine lines, but also declining skin elasticity and changes in the fat, muscles, ligaments, and other supporting structures around the eyes, all acting together.

The same goes for everyday care. Eye creams with moisturizing ingredients help fill the stratum corneum with water and soften skin texture. Using sunscreen year-round is also a helpful way to slow down aging.

However, there are stages that daily care alone cannot resolve. At that point, you need to separately assess which structures have changed.

2. What do I check before the skin around the eyes?

Facial muscle illustration labeling the corrugator supercilii and the orbicularis oculi, with its orbital and pretarsal parts.

The area around the eyes contains not only very thin skin but also a complex network of fat, ligaments, muscles, and bone.

Among these, I first look at the condition of the orbicularis oculi, the muscle around the eye used to close and open the eyelids.

In some patients, skin elasticity declines first. In others, the condition and supportive strength of the orbicularis oculi differ, and in still others, changes in fat position are more pronounced.

Eye sagging may look similar on the surface, but the underlying causes can differ.

That's why I tend to be wary of presenting any single procedure as the answer in eye treatment.

What matters first is not what to use, but which structure to address and how.

3. Can muscles be strengthened through training?

Every time we make an expression or open and close our eyes, the muscles move, and the skin, fat, and other supporting structures respond together.

With age, the skin thins and fat loses volume. Most of these structures are difficult to reverse and are better managed to slow their progression.

Muscle, on the other hand, is an area that can be strengthened through training and conditioning.

In a study I cited at the symposium, 108 women received electrical stimulation to their facial muscles for 20 minutes a day, five times a week, over 12 weeks.

As a result, the thickness of the zygomaticus major, which plays an important role in lifting the face, was reported to have increased by 18.6%.

In addition, more than 80% of participants reported improvements in firmness, skin tone, and lifting.

These results were measured under the study conditions, and individual results may vary.

In other words, by stimulating and strengthening the muscles that support the face, the muscles may become firmer through repeated training, even as other structures change with age.

I believe this is an important point in treating eye wrinkles and lifting.

4. What is “Muscle Conditioning,” which I emphasized in my presentation?

That's why I also consider “Muscle Conditioning.”

This approach provides appropriate stimulation to the muscles around the eyes while using RF to improve skin condition at the same time, allowing us to view the eye area in a more three-dimensional way.

Improved muscle condition creates support for the eye area (Better Support), and building on that, leads to improved skin condition (Better Skin). This was the core concept of my presentation.

The area around the eyes is especially delicate. Each person differs in eye-opening strength, expression habits, skin thickness, fat volume, eyebrow position, and the shape of the under-eye area.

So applying the same energy to eye wrinkles in the same way does not produce identical results. This is not an area where one-size-fits-all works.

Ultimately, what matters more than the device itself is how we assess each patient's eye structure and decide which area to treat, at what intensity, and in what sequence.

5. How does TriLift differ from other eye procedures?

A woman with closed eyes as a handpiece is applied to her cheek.

The device's main unit with its touchscreen and two large handpieces.

TriLift uses DMSt to selectively stimulate facial muscles, inducing muscle contraction and conditioning, while simultaneously delivering energy to the skin with tripolar RF to help improve skin condition.

The difference from other approaches lies in considering both muscle and skin together.

There are also reports of studies combining muscle stimulation and RF.

In a 2020 study, Gold and Biron applied tripolar RF and muscle stimulation simultaneously to 11 adults, administering six treatments in total, once a week. They reported that skin firmness indicators improved at one and three months after the final treatment.

The treatment area covered the entire face, including the eyes and mouth.

In a 2013 study, Potekaev and Zhukova used the same approach to measure forehead lines, crow's feet, and nasolabial folds, and reported that the appearance of the wrinkles decreased by about 30%.

Both studies were small, and because the results were measured under study conditions, individual results may vary.

6. What did this presentation leave me with?

Two side-by-side close-ups comparing the under-eye area.

This TriLift Eye presentation went beyond simply introducing how to use TriLift to improve eye wrinkles.

Drawing on the clinical experience we have built up treating patients at Pixel Lab Plastic Surgery Clinic, the more meaningful part was considering from which perspective both the skin and the muscles around the eyes should be addressed to improve eye wrinkles, and working to establish this as a single protocol.

Rather than simply listing various treatment options, Pixel Lab Plastic Surgery Clinic focuses on setting criteria for which approach a patient with a given structure needs.

An attendee takes a closer look at the device and its handpiece at the event.

The symposium audience listening to a presentation in the hotel ballroom.

I believe that academic activities like this go beyond sharing knowledge. They feed back into actual clinical practice and become the foundation for designing more precise treatments for each patient.

Even for the same eye wrinkles, the approach differs depending on which structure has changed first.

At Pixel Lab Plastic Surgery Clinic, we first evaluate the structure around the eyes, then decide together with each patient whether to start with the muscles or the skin.

If eye wrinkles have become a concern for you, we encourage you to come in for a consultation and check your current condition.

Thank you for reading this long post.

*This post was written directly by Pixel Lab Plastic Surgery Clinic for the purpose of providing medical information and promotion, in compliance with Article 56, Paragraph 1 of the Medical Service Act. All treatments and surgeries carry a possibility of side effects that vary by individual, so we recommend making decisions only after thorough consultation with qualified medical professionals.

References

Potekaev N, Zhukova O. J Cosmet Dermatol Sci Appl. 2013;3(2):151-156.

Gold MH, Biron J. J Cosmet Dermatol. 2020;00:1-6.

Lemenheh MA, Niamtu J. J Cosmet Dermatol. 2021;20:1352-1360.

Frequently Asked Questions

Can eye wrinkles be improved with moisturizing alone?

According to the clinic director, moisturizing alone does not smooth out eye wrinkles well. This is because eye wrinkles involve not only the skin surface but also the muscles and supporting structures around the eyes. Moisturizing eye creams help fill the stratum corneum with water and soften skin texture.

What factors contribute to eye aging?

Along with changes on the skin surface, eye aging involves a combination of declining skin elasticity and changes in the fat, muscles, ligaments, and other supporting structures around the eyes. The director explains that eye sagging that looks similar on the surface can have different underlying causes.

What is checked before eye treatment?

Director Song Jong-geun explains that he first checks the condition of the orbicularis oculi, the muscle around the eyes used to open and close the eyelids, before the skin. He notes that even for the same eye wrinkles, whether to start with the muscles or the skin depends on which structure has changed first.

Can muscles also be strengthened through training?

Yes. He explains that muscle is an area that can be strengthened through training and conditioning. In a cited study, 108 women received electrical stimulation to facial muscles five times a week for 12 weeks, and the thickness of the zygomaticus major was reported to have increased by 18.6%. Because these results were measured under study conditions, individual results may vary.

How does TriLift work?

TriLift is introduced as a device that uses DMSt to selectively stimulate facial muscles, inducing muscle contraction and conditioning, while delivering energy to the skin with tripolar RF to help improve skin condition. The difference from other eye approaches is described as considering both muscle and skin together.

Why is a consultation necessary before eye treatment?

The post recommends making decisions only after thorough consultation with qualified medical professionals. The area around the eyes varies from person to person in skin thickness, fat volume, eyebrow position, and more, so the same treatment may not produce identical results.