Do you recommend upper eyelid surgery, or both upper and lower? I always look so tired (Photo)

From the photo- you appear to be a candidate for upper lid blepharoplasty, and possible fat transfer to the tear trough region. In person exam is essential. Seek an experienced Board Certified PS

Thank you for the question and pictures.My philosophy on facial rejuvenation is to address the face in sections.The upper face, the midface and the lower face.  The upper face include the brow, the upper and lower lids.The midface includes the tear trough, the cheeks, the nasilabiial folds and the jowls.The lower face include the neck.I think depending on your goals, you may benefit from an upper face lift, ie brow and upper and lower lid blepheroplasties.Best regardsNagi T Ayoub MD, FACS

It appears that there is extra skin in the upper eyelids.  This would respond very well to upper eyelid blepharoplasty.  In the lower eyelids is not any fat bulge and there is no extra skin.  There is only wrinkling in the skin in the lower eyelids.  This should respond  well 2 Thermismooth treatments followed by ResurFx treatments and IPL.RegardsDr. J

Your pictures appear to show you to be a good candidate for upper and lower blepharoplasthy. When appropriately performed by an experienced plastic surgeon you should get a refreshed look to your eyelids.

A sad and tired look is usually associated with both eyelid and brow problems. No doubt you would benefit from both upper and lower blepharoplasty but an in-person exam is necessary to determine how much your brow descent contributes. I think you can look forward to very pleasant results.

You could do an upper lid bleph.  May also have some ptosis so see an oculoplastic surgeon so that can also be corrected.  (tough to tell in these pictures if you have true ptosis).  For the lowers:  you have some crinkly skin and volume deficit.  Would do well with pinch of skin, some laser resurfacing, and some sort of filler. It doesn't look like you have enough fat in the lid to reposition.  So either a fat transfer, or some HA filler.        

I would recommend based on your photos you consider upper and lower eyelid surgery.  Although the lower eyelids do not seem to have an over abundance of fat, they do appear to demonstrate some laxity  By tightening the muscle and the suspensory ligaments in the lower eyelid, a more youthful look can be achieved.  Additionally laser resurfacing will improve the texture and color of the lids. 

Based on your photos, I would say you do appear to be a good candidate for upper eyelid surgery.  In regards to your lower eyelid area, you do not appear to have any fat causing bags under your eyes but the skin could be tightened in that area.  There also appears to be some discoloration under your eyes.  The skin could be tightened with surgery but you might get more benefit from laser resurfacing under your eyes to tighten the skin and improve the discoloration.  

Thanks for your post. Based on your photo, you appear to be a good candidate for both upper and lower blepharoplasty. What you should do ultimately depends on your goals and what bothers you. I recommend you visit an experienced facial plastic/oculoplastic surgeon in your area for an in-person examination and discussion of your goals. Good luck!

Distortions of, or
deviations from, this shape may be secondary to heredity, aging, paralysis,
trauma or previous surgery. This
distortion of shape inevitably manifests as rounding of the fissure with
inferomedial descent of the lateral canthus and concomitant descent of the
lower lid margin. Lateral canthopexy, the surgical repositioning of the lateral
canthus is fundamental to altering or restoring the shape of the palpebral
fissure.Canthopexy
procedures which simply reef or attach the lateral canthal tendon to the
lateral orbit periosteum provide sufficient stability and accuracy as
prophylaxis against and to correct mild postblepharoplasty lid malposition.

Bridge of
bone canthopexy’ has found greatest utility when significant movements of
canthal position are required.