Alternative to Blepharoplasty?

Are there other choices for under the eye besides Blepharoplasty? I do not have dark circles but look tired all the time. Thank you.

Doctor Answers 7

Much depends on your actual issues.

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Dear Tired

Without photographs, one can only speculate regarding your issues. Depending on your issues, age, and condition of the lower eyelid skin, options vary. If your skin integrity is good, lower eyelid fillers can do more than surgery to improve many under eye issues. If the skin is crepey, a chemical peel done by a master chemical peeler is a much better option than laser resurfacing. The stimulation of collagen in the lower eyelid skin will push back lower eyelid fat and the result can be amazing. I invite you to look at my website: to review before and after pictures to understand the alternative to eyelid surgery.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fillers or fat injections.

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The "tired" look is most often caused by bags with a hollow under the bags. Fat injections, if expertly done, work great to create a smooth, fresh lower eyelid. But this is a kind of surgery also. I assume you are trying to avoid surgery.

In that case, small amounts of Restylane injected DEEPLY in the under eyes can help a lot to make you look less tired.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Tired looking eyes

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#1- Crepey or sagging skin - surgery is the best way to treat this problem. You can also have a topical treatment to tighten the skin. These treatments include lasers, intense pulsed light and chemical peels.

#2- Deep grooves under the eyes and extending onto the cheek. Fat injections are the best way to treat these problems. other fillers can help, but often cost too much for the necessary volume to correct the problem.

#3 - sagging eyelids (eyes look less oval and more round) - only surgery will correct this problem

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

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Fractional laser resurfacing can freshen under eye skin

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If you only have skin aging changes such as wrinkles and pigment then fractional laser resurfacing can help refresh the skin. Mild skin tightening is also possible.

IPl (intense pulsed light) can also remove brown pigment caused by sun damage.

I avoid injections around the eyes. Fillers are used by many but the eyelid skin is so thin that visible lumps are possible after injections of fillers like Restylane, Juvederm, and others.

Modern transconjunctival blepharoplasty with fat repositioning or fat grafting avoids a visible skin incision, does not change eyelid shape, and is a less invasive procedure that can prodiuce excellent results.

See before and after photo of fat grafting.

Perhaps fillers

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Blepharoplasty will remove excess skin, and fat pads.  During the procedure the lids can be tightened and the eye shape can be changed.

Fillers can help fill in depressed areas.  Laser or Coblation can tighten skin.


Alternatives to Traditional Blepharoplasty

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Traditional lower blepharoplasty addresses primarily puffiness of the under-eye area. Depending on the technique used, excess skin and muscle can also be removed.

Modern approaches the the lower lids go further than that though. We realized that fat removal alone can lead to hollowness rather than a better look. For that reason, volume changes may give many people the best improvement. This has to be tailored specifically to your anatomy and desires, therefore the consultation with a facial plastic specialist is paramount.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 50 reviews

How about makeup?

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Without seeing you, it is impossible to know what you want to correct. As a matter of fact - blepharoplasty does not correct color - it removes the fat that causes dark shadows and the excess skin of the uppers that causes hooding.

See a qualified plastic surgeon for a consultation.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.