Eye Rejuvenation - What Do I Need Done? (photo)

I don't know what would be the best procedure(s) to have done. I'm in my 20's and my tear through area is hollow and gaunt. I have shadowing in my tear through area. I'm not sure if its from this and a combo with my eyebrows too? My eyebrows sag at the temple area, which probably has caused the tear through area to sag. My left eye's upper lid usually droops down more than my right, making me look asymmetrical. My brows are asymmetrical too. Sigh.... Send me a PM for more pictures and help

Doctor Answers 7

Tear Trough Filler and Upper Lid Eye Rejuvenation

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Looking at the photo of your eyes, you have a few choices to enhance the tear trough area. As an oculofacial plastic & reconstructive surgeon practicing in New York, I typically use an Hyaluronic Acid filler such as Restylane, and platelet rich plasma to treat hollow tear troughs. As far as your upper eyelids are concerned, excess skin can be managed by an upper eyelid blepharoplasty, but you have to be certain about your desired look after eyelid surgery before moving forward. If you are interested in eyelift surgery for the upper lids, I recommend consulting with a qualified surgeon who specializes in eyelid sugary.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Several features to consider

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Over all I have to say your eyes really look quite normal. Yes you do have some asymmetry, slight ptosis  and brow asymmetry as well.  Your tear troughs appear fairly mild at least in this photo with this lighting. All of these features are normal and quite mild in your case. That doesn't mean they don't bother you and I understand this. I think rather than undergoing surgery at your age you might benefit from a small amount of filler to the tear troughs and wait to see if the other issues get worse before considering surgery.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

To fill or not to fill....

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Brow asymmetry, mild lid ptosis, lower lid retraction, tear trough concerns, orbital differences, etc. will all play an important role when you are fully evaluated in person by a qualified Cosmetic Surgeon.  Consider your own realistic expectations as you proceed.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

A combination of issues...

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You have a series of mild eyelid changes that one can see from the photo you provided:

1. Mild upper eyelid ptosis [eyelid droop]. This may be leading to issue number 2.

2. Eyebrow asymmetry. Left eye brow is higher than right. This may or may not be related to the slight upper eyelid ptosis. An exam in person would help clarify this.

3. Lower eyelid retraction [scleral show below the cornea] with mild fat prolapse and a prominent tear trough. Fillers might be a good first line treatment for this problem.

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Hollows in the lower eyelids

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Thanks for the photos!  With eyelid evaluation, a physical examination is also necessary.  Without this exam, it is difficult to fully assess the best treatment for you.  A possible solution may include filler to the tear troughs and lateral brow.  


Michelle R. Yagoda, MD
New York Facial Plastic Surgeon

Eye rejuvenation

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Without an exam, it is difficult to assess what tis wrong. However, I will say that everyone is a bit asymmetric.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Eye Rejuvenation

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I would suggest trying less invasive procedures at first.  Some Botox along the lateral orbital rim will help relax the orbicularis muscle and elevate your brows.  Some Juvederm or other HA filler along the inferior orbital rim and in the tear trough area will help the hollowness.  For more specific suggestions or a complete evaluation you would need to be seen in person so we can inspect your anatomy more closely that what is seen in the pictures.


Good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.