How can I stop being told I look tired?

Plastic surgery is pretty extreme. You should consider baby stepping by going with an injection like restulane which may fill in depressed areas under the eyes, or fill wrinkles such as crow feet.

I had a laser facelift -- it's not really a facelift, but the laser refreshed my under eye areas.

Under eye puffiness could be from a lack of sleep, excessive salt or alcohol intake, retaining water or the dreaded heredity. Sometimes the puffiness is the result of a fat pad that cushions the eye pulling away from the bone and sagging due to age. If you truly have excess skin that is sagging. Then yes, eye lift surgery would be a good choice. A mid face lift or an endoscopic face lift can also pull up sagging skin under the eyes. These choices are a cost commitment but would permanently reduce the puffy skin.

Mesotherapy is a plastic surgery alternative that is said to reduce fat deposits and under eye puffiness without surgery or downtime. The number of superficial injections that you need will vary from person to person but could be 20 sessions at $200 a pop.

You should consult your doctor because kidney or heart problems, steroid use and other medical conditions that cause water retention can create puffiness under eyes.

I am considering the LIFESTYLE LIFT. I have been reading comments from your site and others and cannot seem to find information as to where an incision is made and if lipo is performed to get rid of excess fat from jowls. Also, where does the extra skin that hangs down under chin (waddel) go?

I was under the assumption that the incision is just under the chin, but I have been reading about patients who have ear scars.

Could you please clarify this for me?

Wait! Don't get plastic surgery! You can look younger by using skin care products without chemicals, harsh additives, or synthetic ingredients (like all the junk that's found in mass-produced products). Use yummy products (like those on edenskiss.com, but there are lots of others) and see your tired eyes and wrinkles disappear. I've been using all-natural products for six months now and they have taken at least 5 years off my face (because my immune system isn't having to cope with a bunch of bad chemicals from my skin care products). NATURAL skin care is the answer!

I would love to have the information about the ultrasound.  Thanks!

We sent a message to Allie (who wrote about the ultrasound under eye circles treatment) to request more information.

In the meantime, here's additional information we have about treating dark circles:

According to the plastic surgeon organization ASAPS, you may want to consider a chemical peel:
...lower eyelid surgery (blepharoplasty) can correct this problem if the darkened appearance is due to eyelid “bags” that cause shadowing, or due to fine wrinkling and bunching of the skin in the area directly below the lower eyelids, called the “tear trough.” If surgery does not completely solve the problem, a chemical peel to the area may help.

Has anyone tried the SkinDream product that Allie is now selling? If you do purchase it, please post a review here. I won't get too excited about it until we get some honest feedback.

Thanks!
David

To echo some of the good information found above:
Often surgery is not really necessary for dark circles under the eyes and a tired appearance. In many cases, this is due to a loss of volume in the area known as the naso-jugal fold - the semi-circle shaped area where the cheek meets the under eye. When this is the case, a filler such as Restylane or Juvederm is a much better idea than surgery, because you need to replace the volume, not remove skin. Here in LA, there are alot of women walking around Beverly Hills with sunken, unnatural looking eyes because of too aggressive blepharoplasty procedures. I have had a great deal of success with simple Restylane injections - it takes 5 minutes, there's limited bruising, no pain and the results last for over a year. This is a new procedure and it takes some skill to do, so not too many doctors do it well. Always ask for before and after photos and find out how long the doctor has been doing this specific procedure. Just because they're a plastic surgeon doesn't mean they're good at injection procedures. I have been doing this for 2 years and there's a bunch of info on my website about it: http://www.westsidemedicalspa.com/non_surgical_bleph.html.
By the way, I tried Mesotherapy for my patients, and I found it to be not worth the swelling and downtime. Results are OK, but you look like a raccoon for several weeks.
I'm also happy to respond to e-mails.
Hope this helps.
Alexander Rivkin MD

Two words: essential oils.
(Only pure ones, needless to say.)

They really, REALLY work.

Im a beauty theapist and I've seen a lot of 'tired' skin conditions. I do think that surgery could be a bit drastic not to mention expensive. Its hard to say without examining your skin properly but it could just be down to a bad diet and maybe even over-cleansing and over-treatment. Our eyes are so sensitive and if you are constantly applying a multitude of products you may be making the problem worse. I know of people that apply anti-aging products around their eyes religiously but the skin is so delicate that it dries out and looks a million times worse! It may be worth while visiting a dermatologist or a beauty therapist to seek some advice from them before you decide to make any big decisions...
Adele

I get the same kind of questions. I take medication that sucks out the moisture from my face and specifically my eyes. This leaves bags under my eyes and makes them look tired. I’ve tried several several products without any improvement. Stuff that costs #3 to stuff that costs $75 – no great results. However… to be nice to a friend of mine because she sells skin care and cosmetics, I bought eye soothing gel from her. I figured what’s some extra money I would have wasted anyways…at least she would get some money… Unbelievably, it works.

Now, I read Dani's blog for all of her tips and advice
and when I need something extra, I just shoot her an email and buy it from her. She now knows what my skin needs and I don’t have to answer the same questions over and over again... are you dry or you oily have you tried..... she already has all of my information.

has anyone had the mesotherapy procedure done for the under eye fat pad removal? If so, were you happy with the results and what should I expect? I would love to see some before and after pics.. Thanks

wow! that is a lot of info to take in for dark circles....I was curious about this because I used to suffer from dark circles really bad....I always got the "you look tired" and the "let's check for anemia" from doctors (just so you know I am not anemic and that is not what I am suggesting) For the last 6 monthes or so I have been using Kate Somerville Line Release Under Eye repair and it works FABULOUS....I love it!

where do you purchase Kate Somerville line release repair kit.

Dr. Rivkin,

Thanks so much for your advice.

I'm a dark-skinned black female and have terrible bags under my eyes -- no problem with dark circles under my eyes. I was exploring mesotherapy to get rid of the bags but, now that I've read your comments, I plan to look at other things as well. Do you think either Restylane and Juvederm would be effective with the issue I'm experiencing? Do you have any advice for what other non-surgical procedures I might consider?

THANKS!

Ruth

Dark circles and bags under the eyes can be hereditary or caused by other factors. Things like cold compresses, tea bags and cucumbers can help the puffiness. There are also some great eye creams and eye masks on the market that will help as well.

Hereditary dark circles are more difficult to alliviate. I would recommend colour correctors (illusion tones). They are cosmetic products that neutralize colour. The way they work is based on the fact that covering a colour with it's opposite colour (on the colour wheel)will neutralize both colours. Since most dark circles are blue or voilet their opposites peach (orange) or yellow will neutralize the colour. The trick is to really look at the true colour of the circles and make sure you are using the opposite colour. Using a concealer or foundation after the coluor corrector will smooth everything out and make it look even more natural.

my daughter, whoe is only 9 now is getting them, she's tried everything, even creams and serums, they work for about an hour makup only strains the look and then its even more noticable then before, she's now gotten so relunctent and with drawn that she comes home,goes upstairs, enters the bathroom door, comes down holding every cosmetic, makeup set,creames etc.in her arms, slumps onto the couch, turns the t.v. to her favorite show, and stair into her hand mirror, and completely blankes out, she hardly does anything anymore, I mean this has agrivated her,I have absalutely NO idea how to make it go away, she hanging with all her what she believes to be an last resort, the option of plastic surgery, she's been begging me and begging me in every way possible to let her do it, notes honts, she ven changed my ringtone, I'm about to give eithen though shes only 9 and its risky, she hardly smiles any more, so if any body reading this has a stradigie besides plastic surgery thats kid- freindly please reply.!!!!!!!!!!!!!

i had thermage done and im only 23 its been six months and i now have really bad hollowing under my eyes im unsure to if this will get worse over time. what can i do ? should i have fillers ? but does this really look natural ? i had temporary aquamid in my lips and you get bumps & it doesnt feel naturaul in the lips is it different for the eyes ? whats the best filler for eyes? & what about fat grafts ?? any ideas anyone ? its really getting me down & its not just the eyes i need something for my sunken cheeks 2 i wish i never had thermage done. i dont know what to do ? any advice would be great! thanx

I have been told my whole adult life how "tired" I supposedly look, while also being told constantly how "sad" and how "young" I supposedly look. all are horribly irritating to me. I do not understand how being told you look "young" is a compliment. I find all three remarks horribly rude. I am not even willing to consider changing anything about my sleeping habits or my face (no surgery, nothing, ever) to change any of this. I think what needs to change are other people's manners. their perceptions and their manners need to change.

I recently had my eyebrows shaped by a professional (for the first time in my life). When I went to work the next day, people thought I had done Botox. There is something about shaping the eyebrows that can make you appear younger and less tired.

I have had dark under eye circles since I was a young child. People can be rude in commenting, someone once told me I looked tired but then said but i dont know you, maybe you always look like that! Some people just have dark circles as a hereditary thing, in some cases diet and other allergens can really exacerbate the problem, and the posibility of kidney problems should not be overlooked.

Topical creams will have little or no effect on true dark circles (dont waste your money),peels may help as might lymphatic drainage massage. Most dark circles are caused by blood pooling in the area so it is really about the particular face you get. The pigment is often worsened by sun damage on top of that and this could maybe be improved by peels or laser. I hope no doctor would do cosmetic surgery on a nine year old, it is sad enough she is so obsessed with her appearance at such a young age. I would suggest pointing out that some celebrities have dark circles (and great makeup artists) and make a scrap book of photos. I have found this useful as a self esteem exercise with young women. Cameron Diaz and Brittany Murphy are both gorgeous and successful but have dark under eye circles.

The only treatment I would personally consider is the laser eyelift would love to hear any comments

Hi Gemfish,

Dark circles under the eyes are a most difficult problem to resolve. If the tear trough hollow is accentuating the shadow, improvement is obtained with a very small amount of Restylane, blending the "bag" with the cheek. If there is an excessive amount of "bag"(fat pad) then surgery can correct it. The most promising "laser eyelift" that is non-surgical is Fraxel re: pair, the brand new fractionated ablative carbon dioxide laser. The early results have been most impressive. Be well and good luck.

Dr. P

Really, I'm telling you one Revitalight LED treatment and you will be hooked! They use this device before the golden globes to help the nominees look fabulous and the doctor that does the extreme make over show uses it to help the people both look great and heal faster. It really is a miraculous device.
It is not expensive and you get results the first time. Usually takes 6 treatments. Check it out, Opra did.

Many doctors keep saying Sculptra and Fat Grafting are the two best methods of re-volumizing the deflated aging face.
They say sculptra and fat grafting are particularly effective in filling out the hollowness around the eyes... above, below and on the sides of the eyes.
Anyone have any further info on how to volumize the hollowness around eyes on an aging face?

I ve had a restylane filler under my eyes 3 month ago.It was great , i look less tired and it improved the dark circles under the eyes.BUT I HAD MORE THAN TWO WEEKS downtime.
Im using lots of creams for my under eye black circles even after the filler.
good luck

I am always tired and have horrible allergies to pollen. I find that using one of those gel masks works great! The look of tiredness can be a multitude of issues with your health. You should do a whole overhaul of your diet and sleep regimen and even your exercise routine.

Dear Gossipgirl11,

Without a picture, it is hard to say what can be done to make you look less tired. A lot of patients that have the complaint that they look tired benefit from what is called a chemical brow lift. A chemical brow lift is a procedure where Botox is used to try to raise and shape the eyebrows. Botox NEVER raises the eyebrows directly. The only way that Botox can be used to raise the eyebrows is to relax the muscles that pull the eyebrows down which allows the forehead muscles to gently raise the eyebrows. If the forehead muscles are strong enough, the injector can slightly weaken the medial (inside) portion of the forehead muscles just a little which will cause the outside of the eyebrows to be raised a little more than the inside of the eyebrows. This can give a very pretty "winged eyebrow" appearance. Care must be taken to avoid raising the lateral (outside) eyebrows too much. If the lateral eyebrows are raised too much, you can look like Mr. Spock on Startrek! If this does happen, don't panic. The injector can use tiny amounts of Botox to bring the eyebrows back down a little so that you can still have the very feminine winged eyebrows. This process usually helps get rid of that "tired look". If you would like to see some examples of this procedure, you can go to http://www.epilution.com/photos.html?category=botox

Michael Sinclair, MD
www.epilution.com

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