I constantly look tired. My eyelids seem to always be sagging or drooping and I have bags regardless of how much I drink (Photo)

What's the best procedure(s) to freshen my eyes?

Doctor Answers 16

Tired eyes...

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You have several options, for your upper eyelids, you have excess skin there, so an upper eyelid blepharoplasty will serve you well, to open the eyes. 

For the lower eyelids, you have a combination of excess skin, mild fat herniation (bags) and volume loss under the eyes. Your options to rejuvenate the lower eyelids are to do some filler and laser resurfacing to tighten skin and improve the hollows, or consider a lower eyelid blepharoplasty- exact suggestion will depend on an examination. 

New York Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

Alweays tired

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From looking at the limited photo it is kind of hard but I think you have a lot of excess skin on your upper lids and doing an upper lid bleph would  great.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Bothersome bags

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Thank you for your question and photo. You do have the appearance of extra skin in the upper lids and some extra skin and protruding fat in the lower lids, but just having eyelid surgery may not be the whole answer for rejuvenating your upper face. I would recommend that you look in the mirror and simply raise your eyebrows while you watch what happens in the upper lids. If all (or most) of the skin excess there goes away, you are probably a candidate for a brow or forehead lift (maybe in addition to the upper lid skin excision for the "crowding" I see on your photo--which is an upper lid blepharoplasty).

As far as the lower lids are concerned, a mid-facial lift might also be considered, which can be done through the incision for the lower lid "lift" (blepharoplasty), along with addressing the fat bulges; also,  the picture sent shows that your lower lids seem to "bow" downwards, indicating a need for lid "tightening", with what is called a "canthoplasty". Obviously there are many factors to be evaluated and discussed, to lead to the best surgical plan for improvement around your eyes. Consult with a Board-certified Plastic Surgeon who dies a lot of facial rejuvenation.  Good luck!

James H. Scheu, MD, FACS
Saint Louis Plastic Surgeon
4.3 out of 5 stars 28 reviews

You need blepharoplasty

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Blepheroplasty is not only your best option but the only option.  You will need blepheroplasty of upper and lower eyelids. 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

I constantly look tired. My eyelids seem to always be sagging or drooping and I have bags regardless of how much I drink (Photo

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Dear Md17
Thanks for sharing.
You have upper eyelid ptosis that is worse on your right. Surgery would be the best option to correct it.
Lower eyelids will need a lower bleph to redistribute and reduce the facty bulge and remove excess skin.
Ideally you would benefit from a Mid face/SOOF lift, but that depends on whether your Surgeon would recommend this after examination
All the best

How best to treat my tired eyes?

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You present the typical appearance that would benefit from an upper and lower eyelid blepharoplasty.  With men it is even more important to not over resect skin which can change the appearance of the upper eyelids, and   remove little or no  fat.  There are many people in the public eye that look different after surgery, and given how much we focus on the eyes in the course of normal communication, that can be very unsettling. The lower eyelids would benefit most from smoothing out the fat pockets ("bags") which is best done through an incision inside the eyelid, and involves both rearranging and removing fat, as well as selectively adding fat where they are circles underneath. This should not change the eyelid shape, and give a very natural refreshed look

"Tired Eyes", Blephroplasty, & Options

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Dear Md17,
Thank you for your questions and photos.
You present with classic history and findings that can be improved  with a blephroplasty 
procedure and post operative tightening of the skin with a  laser: CO2RE or RF: Thermi smooth or sublime.
You already have a bit of scleral show and would recommend a transconjunctivial approach for removing/relocating the lower lid bulging fat.
Please make several appointments with experienced Plastic Surgeons who listens to your specific desires and who are not only Certified by the American Board of Plastic Surgery but in addition ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes,

Dr. R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery

Blepharoplasty is the treatment of choice for your tired eyes

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 Thank you for sharing your question and posting your photograph. You have extra skin on the upper and lower eyelids as well as additional fat. The skin should be tightened and the fat should be removed from all four eyelids. You may also consider having Erbium Laser skin resurfacing performed to smooth out the skin. See a board-certified oculoplastic surgeon for comprehensive evaluation and discussion of potential treatment options. Good luck. 

Blepharoplasty candidate

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 The primary goal of upper eyelid surgery is to remove excess skin touching the eyelashes which improves the " tired look". The incision is located directly in the upper eyelid crease. The primary goal for lower eye lid surgery is to remove the fatty deposits creating the " puffy look". A small amount of skin can also be removed when necessary on the lower lids. The fatty deposits are removed through a trans-conjunctival approach with the incision placed on the inside of the eyelid. The procedure is performed under a brief general anesthetic as an outpatient procedure. Anticipate 2 weeks of bruising and swelling afterwards. For many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Looking tired

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  I agree that there are multiple options to rejuvenate you periorbital area and that the photos are of rather limited help in determining the best option for you.  I certainly disagree with the idea of injecting fillers to your tear troughs as you appear to have prominent festoons which may be worsened by this treatment.  My best advice is to see an eyelid specialist.  Check the asoprs.org site for one in your area.  Good luck!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

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