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.