Question: I’ve been hearing about Endymed for eyelid rejuvenation because my eyes look tired. While I prefer not to have surgery, I wanted to know if Endymed actually works? I have hollowing of my lower eyelid with dark circles plus sagging skin and bulging fat in my upper eyelids.

Answer: The explosion of non-surgeons and non-specialists entering the cosmetic industry has led to increased marketing of quick-fix, non-surgical alternatives that promise results similar to surgery and/or time-honored treatments. When considering how effective a cosmetic procedure is, there are several rules that can help guide you in the right direction.

■ When it sounds too good to be true, it usually is.

■ If it’s an inexpensive, quick-fix treatment that doesn’t require a high enough skill level such that it’s easy for everyone to do, then more doctors would be offering it.

As far as your question regarding Endymed, there are many similar devices that tighten and resurface the skin. Endymed is being marketed as a non-surgical eyelid lift but if you see the before and after photos in patients who have only had Endymed, the results are minimal and not very impressive. The key here lies in looking at before and after results that are purely from Endymed where other procedures have not been performed in the eye area. Like other fractional resurfacing devices that have been on the market for years, Endymed can only tighten and smooth out the skin in its surface layers but won’t work on deep wrinkles nor will it treat wrinkles due to muscle contraction. Endymed also won’t remove your fat.

True hollows under the eyes that are causing dark circles usually have to be treated with injectable fillers like Bellafill – the 5-year filler or Restylane, Juvederm, or RHA collection for volume restoration. The deep lines and significant crepey skin of the eyes more often require combination therapy with micro-Botox, lasers, and Infini Genius RF micro needling. Bulging fat and excess skin of the upper or lowers eyelids almost always requires a surgical eyelid lift in order to see effective results.

When it comes to Endymed treatment around the eyes, ask how temporary the results will be. When considering a cosmetic procedure, regardless of whether it’s surgical or non-surgical, it is important to go in with your eyes open in terms of the effectiveness of treatment, duration of results, and value for your money.

Too often, a doctor who does not offer the full spectrum of options that range from surgical to non-surgical can entice you into doing the least invasive treatment only for you to later find that it didn’t work as well as promised or it didn’t last very long.

A detailed consultation with a Board-certified Facial Plastic Surgeon who specializes in the face and neck and offers the full spectrum of aesthetic options is the first step in assessing your facial rejuvenation needs.