The Covid pandemic has altered society in so many ways. The overarching effect is perhaps a general reappraisal of how we perceive the future in terms of distanced interpersonal relationships and challenged societal values.

Covid and associated facial masking is predicted to be with us for an indeterminate period.

In fact, the imposition of the mask has become symbolic of the Covid era, emphasizing the expressiveness of eyes alone as the most important facial feature. If we set aside verbal communication per se, it is with the eyes alone that we are obliged to communicate.

However, in an historical context, some cultures have only permitted eyes for public display in nonverbal communication. In certain parts of the world women cover their hair and part of their face. Many of them rely on eye communication enhanced by the application of alluring makeup.

In the culture of ancient Egypt, powerful women like Queen Cleopatra or Queen Nefertiti are depicted to have made the most of their eyes by applying heavy makeup around them to enhance an impression of both power and beauty.

Eyes can indeed express a repertoire of emotions from happiness to sadness as well as joy, sorrow, certainty, doubt etc. Interestingly only humans are capable of expressing such a wide range of emotions with their eyes.

Observation of archival footage featuring the late Princess Diana demonstrates how she mastered the art of expressive, albeit often sad, eyes.

The iconic actress Sophia Loren was also recognized for dramatically expressing her inner feelings though the medium of her eyes. One rather disdainful visual expression comes to mind in a superb photo of her critically observing the amply displayed bust of the neighboring fellow actress at her table, Jayne Mansfield.

In the Covid era preventative protocols are in place to protect people from the spread of this virulent virus.  Both men and women alike wear face masks in public.

Prior to Covid, most people used their full facial aesthetic to express themselves promoting eye contact with others. Eyes smiled, complementing the felicitous expressiveness of the entire face.

All muscles in the face worked together to express our emotions and feelings. In the Covid era this “orchestration” of expression has become practically impossible. With the lower part of the face covered by a mask, the assembly of expressive feelings and emotions become limited to the upper half of our face. Eyes have become the most important facial feature, regardless of gender. 

However, what if eyes are not able to properly covey true feelings? Genuine positive expressive intention may be misinterpreted by the observer as fatigue or sadness.

Accordingly, aesthetic medical proceduralists have adapted to a particular focus on the ocular/periocular regions. Covid surgical precautions notwithstanding¹, along with periocular botulinum toxin fillers, blepharoplasty surgery is in high patient demand.²

Patients are frequently surprised by the minimally invasive and abbreviated downtimes associated with aesthetic injectables and even blepharoplasty surgery. Many minimally innovative techniques have been described for blepharoplasty surgery.^3,4,5 Both the upper eyelids and the lower eyelids can be rejuvenated with minimally invasive surgical techniques, minimising scars but maximising outcomes.

A particularly interesting advance technique has been developed for lower lids that utilises the advantages of transconjunctival fat reduction along with cutaneous mini-incision for tightening of any excess skin but avoiding the traditional complications of transcutaneous lower-lid blepharoplasty, such as scleral show, rounded lateral canthus and ectropion.⁶ Furthermore, in the current pandemic circumstances, patients can take more opportunities to recover at home after treatments.

Now that there has been a necessary focus on ocular beauty during the masked Covid era, it is highly probable that even after obligatory facial masking eases, patients and doctors alike will remain forever mindful of ocular/periocular aesthetics and the advancement of minimally invasive techniques.

Reference
1. Paul D. Langer, MD- Newark, New Jersey Francesco P. Bernardini, MD- Milano and Genova, Italy Oculofacial Plastic Surgery and the COVID-19 Pandemic: Current Reactions and Implications for the Future, Ophthalmology; Volume 127 Issue 9, e70-e71, September 01, 2020
2. https://www.newbeauty.com/covid-eyelift-procedures
3. Bouzouaya C, Feiner R. The ‘Chedly C’ Scarless Blepharoplasty Prime Journal Jun 20, 2019
https://www.prime-journal.com/the-chedly-c-scarless-blepharoplasty
4. Bouzouaya C. Radiosurgery, an effective and efficient technique for cosmetic eyelid surgery. Ocular Surgery News. February 1, 1999:37.
5. Bouzouaya C. Mini-incision lower lid blepharoplasty reduces post-operative complications. Ocular Surgery News. September 1, 2001:71.
6. Bouzouaya C. Mini-lift lower-lid blepharoplasty A safe approach to rejuvenation Aug 27 2013
https://www.prime-journal.com/mini-lift-lower-lid-blepharoplasty-a-safe- approach-to-rejuvenation