There are several things that can make an eye look tired or puffy at any age. These include the brow position, fullness or hollowness on the upper eyelid, and the position of the eyelid itself. Each patient is unique. If the brow is low a brow lift done surgically or with Botox can help improve the appearance of the eye. Extra skin on the upper eyelid which is often a genetic issue (it runs in families ). can create a similar tired look. This can be addressed with an upper eyelid blepharoplasty. This is a removal of extra skin and often entails sculpting some fat in the same area. Finally, eyes can look tires simply because the eyelid itself is low. This can be addressed by tightening a muscle on the upper eyelid either from the inside (no skin incision) or on the outside with an incision in the normal crease of the eyelid. Your pictures are helpful but I would suggest making a consultation with a surgeon who is experienced in eyelid surgery to help discern the true cause of the tired and puffy look and help guide you safely to your aesthetic goals.
It is difficult to tell from photos, but as discussed below, it appears that you may have ptosis. While the standard treatment for ptosis is surgery, sometimes a few units of botox injected into the platform of the eyelid can give a little lift to the eyelid and result in less tired appearing eyes and sometimes addressing the brows can also help. In some cases, slight skin tightening with a non invasive device such as ThermiRF smooth may be an option. Seek out an oculoplastic surgeon who is also an injection specialist if you can to learn about which options would be best for you.
Any type of ptosis repair can help you with your tired look eyes. But not blepharoplasty alone. You may benefit from Mullerectomy, as well as Levator advancement. But I prefer to perform Mullerectomy for young patient since it has no external scar.
The photos show bilateral eyelid ptosis. This means the levator muscles that open the eyes are a bit lazy or possibly too loose. You need a careful evaluation which requires a consultation to determine the cause. Eyelid surgery (blepharoplasty) can help your eyelids open better, but if you have true ptosis you would need that corrected as well. Botox, if done correctly can raise your eyebrows which might help a little, but I think surgery is your best bet.
Thank you for your question about your eyelid surgery.
your photos suggest that you have bilateral (both sides) ptosis or drooping of the upper lids.
This is usually from weak muscles that open the eye lids.
Correction is with surgery.
The condition runs in families - although there are many other causes.
See a plastic or opthalmoplastic surgeon.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
The most common solution for patients concerned with "tired eyes" is blepharoplasty of the upper eyelids even in patients in their 30s or younger. Consult with 3 experienced and expert board certified plastic surgeons to understand your options.
The other common alternative is botox to lift the upper lids and dermal fillers (most commonly restylane or belotero) for the hollow area for the puffy fat.
Consult in person with 3 experienced and expert board certified plastic surgeons who are master injectors to understand your options.
The eyes are the windows to the soul. All too often, however, they seem to
reveal exhaustion. The very delicate skin around the eyes tends to get crepey
and puffy due to fatigue and stress. Eyelid surgery has become one of my most
popular procedures. If excess upper eyelid skin is hooding the eye and needs to
be eliminated, an incision is made in the crease at the top of the lid and
excess fat and skin are removed. The incisions are closed and sutured on the
underside of the skin. If under eye puffiness and dark circles need to be
eliminated, an incision is made along the lower lashes that will be almost
invisible when it heals. Next, the fat below is either removed or redistributed
and the saggy and crepey excess skin is then pulled up and cut off. The incisions
is closed with tiny sutures, which are removed in four to six days.
An effective non-surgical option that might benefit you is Thermage, which can
tighten the skin around the eyes. The new and improved Thermage is a virtually
painless, non-invasive (no incision!) treatment that can tighten skin and
stimulate your body to make healthier collagen—the building block that provides
structure to your skin. Fast and easy, Thermage requires no downtime from
The main problem seems to be ptosis of your upper lids. The drooping of the lids causes you to elevate with your brows. You need to have ptosis surgery by an oculoplastic surgeon. At the time of surgey you may benefit from removal of some of the excess skin. Good luck.
Both upper eyelids are droopy. The left upper eyelid is slightly droopier than the right side. I will tell you flat out, do not let anyone cut skin or fat out of your upper eyelid. You are young and need upper eyelid fullness. To compensate for the ptosis, you raise your eyebrow. You will look much more attractive with the eyes more open and this will allow the eyebrows to relax down. Botox will not correct the upper eyelid heaviness. Instead most botox treatment flatten the forehead and drop the eyebrows (think Renee Zellweger). You won't like that. Your challenge will be to find an oculoplastic surgeon who thinks like I do: less is more. Don't let anyone push you into doing the wrong thing because it is very difficult to correct this. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website to help you find a well qualified surgeon close to home. Their url is listed below.
Thank you for your question and photos!
For eyelid position- botox can help lift the upper eyelids, it will open up the eye- resulting a more alert appearance. For the lower lid - the hollow area below the puffing fat can be contoured with fillers. There is also the surgical options.
With Warm Regards
Trevor M Born MD