Age: 40. Puffy Bags under eyes when smiling, eyes got smaller over the years. Suggestions?

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for a lower bleph procedure as that procedure will remove fullness and excess skin to your lower eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!

It is very likely, based on these photos, that a lower blepharoplasty would significantly improve your current situation. In person consultation with a board certified plastic surgeon with expertise in blepharoplasty is recommended. Good luck.

Looking at the photo, there are noticeable deep wrinkles under the eyes. These become even more prominent when smiling, especially in the lower eyelid area.The skin under the eyes is typically very thin, which makes it more prone to wrinkling and sagging. Because of this, simply improving the eye area can make the overall face appear much more youthful. Through lower blepharoplasty, we can address these concerns and create a brighter, smoother under-eye appearance.As for the upper eyelid, upper blepharoplasty is not recommended in your case, as the space between the eyelid and the eyebrow is quite narrow. The most likely and effective approach would be a forehead lift. By lifting the forehead and eyebrows, we can improve the drooping skin covering the eyelids and create the appearance of larger, more open eyes.Since the full face is not shown in the photo, it's difficult to say with complete certainty which procedure would be best for improving the upper eyelid area. However, based on what we can see, a forehead lift is the most recommended option.