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I'm tired of looking tired. What should I do? (Photo)

I have bags under my eyes, which I think are hereditary. My mother has them, her father had them, some of my siblings have them. Any suggestions?

Doctor Answers (15)

Fillers And Neuromodulators Work Well For Hollows And "Tired" Eyes

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Today we have a number of very gratifying nonsurgical eye unit rejuvenation procedures that involve no cutting, no stitches and engender little or no downtime.

Many of the changes we typically encounter in the lower lids with the passage of time--namely tear trough deformities, hollows and bags, result from shrinkage, shriveling, and a downward descent of the once robust, heart-shaped fat pad that sat immediately under the lower lids and extended out toward the temples, inward toward the root of the nose, and downward about half-way to the angles of the mouth. The loss of this volume and its downward displacement in the direction of the jaw (due to weakening of the supporting ligaments and the downward pull of gravity) elongates the lower lid to several times its narrow youthful width and leaves it somewhat sunken. In addition, like a balloon having lost its air after being fully inflated for a long while, the skin of the lower eyelid fails to snap back to its youthful smoothness, and instead remains crinkled and baggy. The result: tired looking eyes.

Happily we can address these problems nonsurgically with the injection of fillers and volumizing agents to restore the volume to the lower lids and recontour them, mask the bags, and diminish the darkish discoloration.A variety of materials have been tried for these purposes. My personal favorites for dealing with tear troughs--for providing overall smoothness, shape and lift-- are the recently approved Belotero Balance and Restylane L. When more cheek support and buttressing are needed for the lower eyelid, the upper inner cheek immediately below may be supplemented with with Perlane L, known for its lifting capacity. It usually takes about five minutes to treat each lower lid with immediate that typically evoke a "Wow!" response from patients when they look in the mirror.

While minimal bruising, tenderness, swelling and redness may occur following treatment in this delicate region, these are usually temporary and disappear spontaneously within one to seven days. Most people can return to work or social activities immediately or the following day and coverup may be used if desired.

From the photo, there are prominent "eleven" lines (scowl lines, frown lines)  between the eyebrows that have resulted from years of movement of the muscles in this region and resulting overlying creasing of the skin. This, too, can contribute to a tired or even angry look. A few microdroplets of Botox or other neuromodulator (Dysport or Xeomin) to soften the overactive muscles and small amounts of a filler, such as Belotero Balance, would further improve the eye unit as a whole and lessen the tired, aged look. 


New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Blepharoplasty or eyelid surgery can often eliminate the tired look

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Thank you for your question and photographs.  A combination of upper and lower blepharoplasty will remove loose skin correct puffiness and open the eyes to give you a more awake look.

Please consult a plastic surgeon who is certified by the American Board of Plastic Surgery, or Ophthalmology, wth special training an oculoplastic surgery.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 34 reviews

Blepharoplasty To Correct "Tired Eyes"

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Thank you for the pictures.  Aging of the eye, and unfortunate part of life, often imparts a "tired", "sad", or even "angry" look to one's face.  Sagging of the eyebrows, excess skin in the upper and lower lids, as well as protruding fat in the lower lids all contribute to this undesirable look.  I think you could benefit from upper and lower blepharoplasty, and possibly a browlift.  Although, this should only be determined after a thorough consultation with a board certified surgeon specializing in facial cosmetic surgery.  Good Luck...I have provided a link below.  

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

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Best Blepharoplasty

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Hi CGG,

Properly performed blepharoplasty would be your best option for rejuvenation.  You should go from "Tired of looking tired" to as Madelyn Kahn complained in "Young Frankenstein", "I'm tired…tired of being admired!"  Choose your surgeon most carefully.  Good luck and be well.
Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Tired of that tired look to your eyes

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Many patient's often feel the same as you do so its good to know that you are not alone in this. The good news is that now we have so many options available to reverse that tired look. There are surgical options and non-surgical options available for patient's. I recommend you visit a facial plastic surgeon that specializes in eye treatment. Often many of them have complimentary consultations available with a patient care coordinator who can go over options and then you can decide what works best for you. Once you come in for a consultation you can see many before and after pictures so you can best decide on the option you want and choose the doctor you feel most comfortable with.

Kristin J. Tarbet, MD
Bellevue Oculoplastic Surgeon
5.0 out of 5 stars 11 reviews

Surgical options for tired appearing eye area

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There are many features of aging that give the appearance of feeling tired.  As for the eyelid area it is the heaviness of the brows, thickening and drooping of the upper eyelid skin and bulging and wrinkling of the lower eyelids.   All of these features can be improved with an upper eyelid blepharoplasty

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Lower lid blepharoplasty under eye bags

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The under eye bags are caused by herniation of 3 little fatty compartments in the orbit that become more prominent with age. A trans-conjunctival approach with an incision placed on the inside of the eyelid can remove them. When excess skin is present, such as in this case, a small pinch of excess skin is removed  through a lower lid lash line incision and closed with tissue glue. For many examples, please see  the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

I am tired of my tired looking eyes, what should I do?

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I would recommend a consultation with a BC PS to discuss surgery to rejuvenate your eyes and roll back the clock, a surgical eye procedure involving the upper and lower eyes would be very effective in achieving a refreshed look. Good luck!!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.5 out of 5 stars 17 reviews

I'm tired of looking tired. What should I do?

+1
You have a combination of features that the observer equates with looking tired. Botox above the nose coupled with upper and lower blepharoplasty would go a long ways to correcting the problem.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Tired Baggy Eyes

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If you are in good health, you are a great candidate for an Upper and Lower Blepharoplasty (4 eyelids)
This procedure will remove the excess skin and bags (fatty tissue) that are causing the problem. The surgery is outpatient surgery. In my West Orange, NJ practice, I use Essex Surgical, a Medicare Approved surgicenter, and Board Certified Anesthesiologists from St. Barnabas Hospital. The entire fee is $4100 including facility, anesthesia, and professional fees. Consult a Board Certified Plastic Surgeon

George C. Peck, Jr, MD
West Orange Plastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.