What can I do about this tired eye look? (Photo)

Question

My upper eyelids always look tired. I get enough sleep but they always look tired. I’m young and healthy. Are my upper eyelids hollow? Or is that because of how my brow bones are shaped? What's a permanent solution? I’m against using synthetic fillers because they always end up migrating and eventually puffing up the face in the future. My eyes are also slightly downturned. They would look better if upturned in my opinion. What can I do about this tired look?

Jason Emer, MD · Answer

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 the situation.

For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

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

Gary M. Horndeski, MD · Answer

Your photographs are limited.  However, your eyebrows are below the level of the orbital rim.  You may benefit from a browlift and this may take care of most of your problem.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey M. Darrow, MD · Answer

You have ptosis of your upper eyelids.  There is a muscle in your upper eyelids called your levator muscle.  The levator is attached to a tiny piece of cartilage in your eyelid.  When you open your eyes, the levator pulls the cartilage up and your upper eyelid should normally open so it covers only 1-2 mm of your iris, which is the colored part of your eye.  If the muscle/cartilage connection isn’t ideal, the eye doesn’t open correctly and the lid position looks low.  Some people are born with ptosis and others develop it over time.  This is also why the crease of your upper eyelid sits so high.  Find someone who performs ptosis repair.  Best wishes.

Tanya T. Khan, MD · Answer

Hello, it looks as though you may have upper eyelid ptosis, as the lids look like they are hovering very close to the pupil. This can definitely cause the eyelids to look droopy. Would consider visiting an experienced Oculofacial Plastic Surgeon for a proper evaluation and possible surgery to correct the ptosis and improve the lid crease position.

A.J. Amadi, MD · Answer

Based on your photos, which frankly aren't idea (they should be taken straight on), you have mild upper eyelid ptosis (upper eyelid are droopy) and a negative lateral canthal tilt (the outer corners of your eye are lower than your inner corner).
This is a natural variant for some people, but most eyelids, the outer corners of the eyelid are slightly higher than the inner corner. The change you are looking for can be achieved with an upper eyelid ptosis repair and a lateral canthopexy.

What can I do about this tired eye look? (Photo)

Answers (5)