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As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.
Hello!First of all thank you for your question.In your case (regarding the photo), you are a good candidate for blepharoplasty + brow lift surgery. It will unfreeze your eye tilt and give a nicer look :)
It would be very hard to evaluate your canthal tilt, based on this photo. You have very heavy. low set brows which may contribute to upper eyelid fulness, possibly creating appearance of negative canthal tilt. Brow lift, endoscopic or open, would significantly improve this condition and possibly eliminate need for canthal transposition/lift. In person evaluation is recommended.
You could do an endoscopic browlift which would not only elevate your brow bur treat your negative eye tilt.