Which procedure would help me achieve a more rejuvenated appearance? (photo)

An upper and lower lid blepharoplasty with a transconjunctival approach for the lower lid would brighten your eyes and rejuvenate you in one step.

Hello, thank you for sharing your concerns. At age 37, it’s very common to notice early signs of facial aging such as under-eye bags, fine lines, and loss of volume in certain areas. Based on your description, there are several approaches that may help restore a refreshed, more youthful look:

Lower eyelid surgery (blepharoplasty): This can reduce puffiness and under-eye bags, making the eyes appear brighter and less tired.

Dermal fillers: These can replace lost volume in the midface and under-eye region, softening hollows and creating a smoother transition between the lower eyelid and cheek.

Skin resurfacing treatments (laser or chemical peels): These improve skin tone and texture, minimizing fine lines and sun damage.

Neuromodulators (Botox): Helpful for softening dynamic wrinkles and refreshing the upper face.

A combination of these treatments often provides the most natural and rejuvenated outcome. Lifestyle factors such as sun protection, hydration, and a consistent skincare routine with retinoids and antioxidants also play a key role in maintaining results.

Hello there Holly,
You look attractive and beautiful. I would treat you with a combination of Profound RF (microneedling with radiofrequency), platelet rich plasma (prp), Sculptra foundational volume replacement, and laser skin resurfacing, all performed at one sitting in our office under local anesthesia (with a little medicine to make you very comfortable.). This is my most aggressive non-surgical treatment to maximize rejuvenation with minimal downtime and natural long lasting results. Results from this treatment continue to improve over a nine month time period. At that time I would re-evaluate whether your under eyes would benefit from eyelid surgery. Whatever you decide, please take care to select your treating physician very carefully based on their skill, experience, care, knowledge, board certification, and most importantly their natural artistic vision. Good luck and be well.
Michael Persky, MD
Encino, CA

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Two options for you could be Sculptra and Autologous fat transfer. Sculptra is an injectable dermal filler that stimulates collagen production, offering a gradual and natural-looking improvement in skin volume and texture. Unlike traditional fillers that provide immediate results by filling in wrinkles or adding volume, Sculptra works over time to restore the underlying structure of the skin. Autologous fat transfer, also known as fat grafting or fat injection, is a cosmetic procedure that involves removing fat from one part of the body and injecting it into another area to add volume, contour, and rejuvenation. This procedure is popular for its natural results, as it uses the patient's own fat cells. Sculptra is less invasive than AFT, but produces shorter lasting and less natural results as the AFT will use your own fat cells and won't dissolve for years. Having an AFT done also requires you to be in good health in order to harvest healthy fat and have an area of the body with extra fat you are okay with harvesting. Both of these options will reduce your eyebags and give you overall rejuvenation.

You appear to be a good candidate for an upper and lower blepharoplasty to freshen the eyes. You can also consider Morpheus8. This treatment combines RF technology with microneedling to improve overall skin tone and texture. We always recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.