My eyes always look tired. What procedure or service could help my undereyes? Lower bleph? (Photo)

Let’s start with the positives! Your brow position is excellent. Your upper eyelids are youthful and symmetrical. Your lower eyelid position is correct. You simply have a small amount of pseudoherniation of the fat from your lower eyelids. This should be easily corrected with a lower blephroplasty under either local anesthesia or general anesthesia. This will smooth the transition between your lower eyelid and your cheek and give you a more youthful and rested appearance. Have a detailed discussion with your plastic surgeon. Best wishes.

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best,
Dr. Emer

From the photos it appears you have a few options to improve the under eye area. Fillers are one option to help smooth contours. The treatment is done in the office with results lasting up to a year. Lower blepharoplasty is a surgery that will address the fat herniation and any excess skin under the eye for a more permanent solution. Morpheus8 is another potential treatment which uses RF technology combined with microneedling to improve overall skin tone and texture. See a board certified plastic surgeon near you to learn more about your options.