My eyes look sad, tired, and sunken lately. The outer half of the upper lids are often swollen. I have festoons. Advice? (photo)

What can I do? Most desired outcome is to look less sad and tired, and if possible, prettier.

Doctor Answers 4

Sad, tired and sunken eyes lately.

Dear Reader,

Thank you for your question. First schedule your consultation with a Board Certified Facial Plastic surgeon.  From your photos, you do look like you could benefit from upper and lower eyelid blepharoplasty.

Laser resurfacing under your eyes could also help with festoons which is edema to minimize the appearance of puffiness (not sure if yours are true festoons) it also helps with dark circles under the eyes, which can give you a tired look. 

Best of Luck!

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Lower lid bleph

I am assuming that it is the lower lids that bother you the most.  You have  a deep tear trough, and some fat prolapse.  You also have some malar edema.  A lower lid bleph with fat repositioning should help the tear trough.  The malar fat pad can also be moved up which should help. Your tear trough is deep enough that you may also need a fat transfer.     

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 28 reviews

Brow and lower lids

rsjr, You could try Botox but I doubt it will be helpful. I suspect I would recommend a full brow lift versus a 3/4 lift and perhaps a SOOF lift blepharoplasty. Search the Internet for more infromation. Always seek the opinion of an experienced specialist. Good luck.

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Lower Lid Appearances

Hi rsjr,
Thanks for your question and photos. In looking at your photos, I can appreciate mild fat prolapse and a prominent tear trough. These are both contributing to the "sad, tired, sunken" appearance you have mentioned. HA filler may be a reasonable conservative option to try and smooth out the lower lid appearance. However, a lower lid blepharoplasty with fat transpositioning would be a more permanent, definitive procedure to fill in those contour defects and obtain a pleasing result.
I would recommend an in-person evaluation with a skilled facial plastic surgeon in your area. 
Good luck!

John McCann, MD, PhD
Sandy Oculoplastic Surgeon
4.8 out of 5 stars 4 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.