What to do with my eyes? (Photo)

I'm 44 and pretty healthy but this past year my eyes really started to bug me my bottom lids especially and now the top seem tired looking any ideas, suggestions?

Doctor Answers 9

Considering eyelid surgery

Dear Rivera, thank you for your question. Blepharoplasty or eyelid surgery can remove loose skin and bulging fat pockets, and enhance the appearance of the upper face. In our San Diego practice we often combine eyelid surgery with fat grafting or a laser peel for best results.Eyelid surgery is not without risks, so consult with an experienced facial plastic surgeon or general plastic surgeon to discuss your options. Good Luck!

San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Blepharoplasty at age 44

 It is difficult to tell from the photograph shown what may or may not be required. The primary goal of an upper blepharoplasty is to remove the  excess skin and a small amount of fat from the upper lid. The  incision is placed in the upper eyelid crease.
The primary goal of lower blepharoplasty is to remove a portion of the 3 fatty compartments in the lower lids creating the" puffy look". A small amount of excess skin can be removed on the lower lids, when necessary by a pinch technique and closed with tissue glue.
For more information about upper and lower eyelid surgery, please see  the link below to our eyelid surgery photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Options for Eyelid Rejuvenation

The eyes are the windows to the soul. All too often, however, they seem to reveal exhaustion. The very delicate skin around the eyes tends to get crepey and puffy due to fatigue and stress. Eyelid surgery has become one of my most popular procedures. If excess upper eyelid skin is hooding the eye and needs to be eliminated, an incision is made in the crease at the top of the lid and excess fat and skin are removed. The incisions are closed and sutured on the underside of the skin. If undereye puffiness and dark circles need to be eliminated, an incision is made along the lower lashes that will be almost invisable when it heals. Next, the fat below is either removed or redistributed and the saggy and crepey excess skin is then pulled up and cut off. The incisions is closed with tiny sutures, which are removed in four to six days.

An effective non-surgical option that might benefit you is Thermage, which can tighten the skin around the eyes. The new and improved Thermage is a virtually painless, non-invasive (no incision!) treatment that can tighten skin and stimulate your body to make healthier collagen—the building block that provides structure to your skin. Fast and easy, Thermage requires no downtime from normal activities.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Eyelid rejuvenation

See an in person evaluation for best answers. You likely will benefit from upper blepharoplasty and either lower blepharoplasty or fillers for lower eyelids.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Irregular Trichophytic Forehead Lift for sad tired eyes.

Irregular Trichophytic Forehead Lift for sad tired eyes is what you need.  Face forward and profile photos are preferred for evaluation.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

What to do with my eyes?

 Fillers can help improve the cosmetic appearance but you will get only a temporary and limited improvement with them. A better and long standing correction would be achieved with a blepharoplasty of the upper and lower lids: Conservatively removing the excess loose skin, contouring the bulging fat pads, which are generally inherited, unrelated to weight, and tend to protrude more with time, and smoothing the tear troughs with micro-fat grafts or fat repositioning.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

What to do with my eyes?

Skin removal from the upper and lower eyelids would probably yield the best result with the smallest level of intervention.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

The pictures are not idea.

Whatever you do, you want a natural result that does not harm the function of your eyelids or cause you to look like you have had surgery.  My initial impression that standard eyelid surgery would not be appropriate for you.  You brows are low and upper eyelid surgery would actually make this worse.  A further fall in the brow will make you look very cross (i.e. angry).  Also you are someone who needs a full upper eyelid fold.  There is no substitute for an actual in person consultation but you look like you would do great with an endoscopic forehead lift, possibly a small anchor blepharoplasty in the upper eyelid and a lower eyelid skin pinch.    Less is more.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

What to do with my eyes?

First of all thank you for the question and pictures.  Looking at your pictures it does appear that you have some ptosis of the upper lid as well as some excess skin in the lower lids.  You certainly would be a candidate for a Blepharoplasty of the upper and lower lids.  I would recommend consulting with a Board Certified Plastic Surgeon to find out your options and what procedure would give you the results you are looking for.  Best of Luck!

Heather Rocheford, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 63 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.