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 thing. Extra skin can only be treated with surgery. Sometimes a combination of both is best. Make sure that the medical provider you see in consultation is able to do both surgery and fillers. You will receive the best evaluation and recommendation when the doctor has a full complement of procedures to offer.
Surgery or fillers for tired eyes
Elizabeth S. Lee, MD answers: 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.
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