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Eyelid Surgery or Fillers First for Tired-looking Eyes?

I am a 43-year-old female that over the last 6 - 8 months have seen a noticeable change in my eyes. Puffiness, drooping eyelids and heavier lines under my eye, some days hollow-looking, other days puffy. I always look tired one way or another Should I look to an surgical eye lift or go with a more tame approach, such as Radiesse, Juvederm etc.? I look as if I aged 3-5 years in this period of time.

Asked 28 months ago by Moncrief in Franklin

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age 35-44 eyelids eyes lines under eyes female droopy hollow puffy eyes

Blepharoplasty or dermal fillers for eyes

Normal changes to the lower eyelids can really make us look older quicker. Injections to the lower eyelids are fine for subtle changes such as small amounts of "pooching" of the fat pockets or hollowing (dark circles and shadows) of the lower eye in younger individuals. For significant changes to the lower lid, a formal surgical procedure is likely going to make you happier than fillers and the outcome will last considerably longer. You can always try a quick dermal filler fix,... more

Philip S. Schoenfeld, MD

Chevy Chase Facial Plastic Surgeon

Options for tired looking eyes

The puffiness around the eyes is caused by fluid retention in the upper and lower lids located in the fat pads underneath the muscle of the eyes. This tends to shift with the time of day and time of the month. Make sure that all allergies are addressed as well as a low-salt diet. We do not recommend any of the fillers injected into the eyelids. If this happens to be injected into the orbital septum it will stay swollen for several years in duration.

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William Portuese, MD

Seattle Facial Plastic Surgeon

Fillers vs. Eye Lid Surgery

The correct choice depends upon your particular situation, A depression or hollowness beneath the lower eyelids, often referred to as the "tear trough" deformity, can give a tired look. In this case a filler such as one of the hyaluronic acid products, (Restylane or Juvederm), or even micro fat grafts can fill in these areas and create a smoother contour. I tend to prefer the softer products for the eyelid region. These are short term solutions. The fillers resorb over time... more

James H. Schmidt, MD

Sarasota Plastic Surgeon

ASAPS ASPS

Try Juvederm/Restylane for Tired Eyes

The tired eye look is usually from a deep tear trough. If you are not sure about surgery then buy some time by getting Juvederm/Restylane in the nasojugal groove (tear trough) and you will look better. However that is good for only six months. Surgery might be the long lasting solution. Regards

Tanveer Janjua, MD

Bedminster Facial Plastic Surgeon

Fill or surgery for tired lower lids, or both?

Aging in the lower lids often does not follow a continuum and can be modulated by inherited lid characteristics. This can also be true of the amount of fatty tissue in the neck. At 43 you are on the early side of surgical rejuvenation of the lower lid though the best assessment will determine the condition of the skin of the lid, and the degree to which the fat in the lid is prominent. I believe that the first signs of aging tend to be a loss of the fat under the skin where lid joins the... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Surgery or fillers for tired eyes

A definitive recommendation can only be made after an in person consultation with a plastic surgeon but you have identified some key questions. We can look tired or older around the eyes because the lids are droopy, or because we look puffy or hollowed out. Fillers are generally not used in the eyelids, but can be useful in the areas around the eyes such as high in the cheek or along the arch of the brow. If a "hollowed out" appearance is the problem, fillers may be just the... more

Elizabeth Lee, MD

Bay Area Plastic Surgeon

ASAPS ASPS

Blepharoplasty or fillers...or both.

A proper evaluation by a surgeon (i.e., someone who can also operate on the eyelids and not just inject patients) would be a good place to start. Some patients, for example, really need a lower blepharoplasty--eyelid surgery--to recontour baggy fat and/or "lift" loose eyelid skin. Others, of course, merely have hollowing and would be better served with fillers such as Juvederm. Others still need a little bit of both. Or neither. All the best, --DCP P.S. Although opinions vary,... more