Would You Advise Blepharoplasty for my Tired Eyes?

Although I'm only 29, I have the "tired-eyes" effect which I've had since I was 18. I have to use a concealer to look fresh. I visited a local doctor and I described my two problems: under eye bags and dark circles, which get darker at the lower side. He told me he can help me using CO2 laser but only with dark color since the ugly hump under my eye is the shape of the eye and it cannot be corrected. Do I really need a Blepharoplasty or a laser will do? Please advise me. I'm wearing concealer in the photo. I can send you high quality photos to have a better look.

Doctor Answers 7

Dark circles and bags under the eyes

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Your eyes do not appear very tired since you are only 29 years old. Dark circles will not get better with surgery. If bags are present on the lower lids at age 29, it is important to make sure that your allergies are under control, there is not fluid retention from a high-salt diet, and any other medical conditions such as thyroid problems exist. If all of those have been satisfied, then consideration for the lower blepharoplasty can be done. Do not perform laser surgery on the lower lids because it will hypopigment the lower lid skin.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Tired appearing eyes

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Dear Wolfcry

As i look out to the rising sun in Paros, Greece- my eyes feel a little tired but the view and your Country are exceptional.

There are several components thaat can contribute to the tired appearance:

1 upper eyelid position

2 decreased volume in the eyebrow and cheek region

3 puffing fat of the lower eyelid

This may be treated with

1 volume addition- to frame the eyes and remove the dark hollows

2 combined with Botox- to shape the eyebrow and lift the upper eyelids

or with

3 Surgery ( which is a little more involved in discussion)

Consider your options,

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews


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 Without examining you in person it is hard to tell. The photo you posted is difficult to see in terms of your anatomical issues.  A blepharoplasty can treat excess fat, reposition fat, and remove excess loose skin.  If the skin has a lot of fine lines, then ablative lasers may help.

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

You need the right doctor for tired eyes

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Hi Wolfcry

Your photo shows that you have upper eyelid ptosis. This makes the upper eyelids droopy and is associated with a sleepy look. You need a surgeon who knows how to actually fix this. It is not the same surgery as simply removing skin from the upper eyelid.

CO2 laser is not the right choice for you (or most anyone else). A better approach for your lower eyelid dark circle would be to fill this area with some Restylane.

As you live in Greece, be aware there are very few properly trained oculoplastic surgeons in your country. However, I can recommend that you see Dr. George Charonis who practices in Athens. He trained in ophthalmology in the United States and also did a formal oculoplastics fellowship at UCLA.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Blepharoplasty for "tired eyes"

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It looks as though you may have excess skin and fat underneath your eyelid skin. If so, blepharoplasty is a good option for you even at the young age of 29. CO2 laser is great, but it will not address the excess fat. The entire blepharoplasty procedure is very well tolerated and the scars are almost imperceptable. Have several plastic surgeons look at your eyes for their opinions and go with the one you feel most comfortable with. It's hard to tell you exactly what you need without meeting you in person. Good luck!

Tired eyes, but not sleepy?

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There are several anatomic reasons that eyes look "tired". The most common is the lower lid "bags" that may be excess of skin, muscle, or fat. Sometimes the cheek fat falls with gravity and reveals the circle of bone where the skin attaches and forms the lower border of the "bag". Your photo suggests an excess of muscle and skin bunching that may be from squinting or allergy. You also have a condition of your upper lids that some describe as "bedroom eyes". This may be due to the lower position of the lateral corners compared with the medial or inner corners of your eyes. This is commonly related to a ligament attachment that may be elevated with surgery for the upper lids or blepharoplasty. Finally, you may want to consider the benefits of cheek implants or brow repositioning to help balance the structure of your orbits.

Blepharoplasty for Tired Eyes

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Dear Wolfcry,

from the attached picture I assume you are the only visible face on the right hand side. Although a closer view would have been easier to analyze, I would like to share my thoughts with you.

You appear to have droopy upper lids (ie Eyelid ptosis). I cannot discern just how symmetric the condition is on both sides. But to keep your upper lids from covering your eyes you appear to need to raise / arch your brows resulting in a frontalis muscle hypertrophy and foreheal lines will follow.

To correct this, depending on the amount and mechanism of droopiness, there are at least 3 different operations to correct ptosis. The operations are done either through the skin of the upperlid (a upper blepharoplasty approach) OR through the upper lid inner layer - the conjunctiva.

Done properly, it should correct the sleepy look.

I would NOT use the CO2 laser. It is early 1990's technology and besides being associated with 6 months of redness, it CAN be associated with depigmentation of the skin and pulling down of the lower lid (ectropion). Placing Juvederm deeply along the tear trough could drastically improve the nasojugal fold - the area you called the "ugly hump" under the eye.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.