Why do I always look angry/tired? My eyes slant down too much. How can I correct this? (Photo)

My upper eye lids are heavy... They've gotten worse over the last two years. When I smile, my eyes disappear into this cocoon of skin! I might be young but I want to fix this. Please advise

Doctor Answers 5

Endoscopic Browlift to Open Eyes

Dear sunnydays27, An in office consultation would be needed to provide a proper diagnosis however in some young patients like yourself when we see hooding of the eyes and complaints of looking tired or angry I often opt for an endoscopic browlift. This helps open the eyes and provides a natural youthful appearance with no tell tale signs of surgery. See some examples in the link below and video above. Best regards, Michael V. Elam, M.D.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 198 reviews

Consider a brow lift

It appears from you photos, that your brows are a little low and this causes the heavy eyelid appearance that you dislike. A brow lift would open up your eyes nicely. 

Elba Pacheco, MD
Annapolis Oculoplastic Surgeon
4.0 out of 5 stars 5 reviews

My eyes slant down too much. How can I correct this?

You have what is referred to as anti-mongoloid slanted eyes, which means the lateral canthus (outer corner of the eye) is lower than normal. You may be candidate for lateral canthoplasty or almond eye surgery. See following link.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 61 reviews

This is significant upper eyelid ptosis.

Both eyes are droopy but the left eye is worse than the right.  See a fellowship trained oculofacial surgeon.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help yo find a highly qualified surgeon in your area.  I would inquire of the office is they accept your health insurance.  A test is often needed to determine if the ptosis would qualify as medically necessary under certain health insurance plans. 

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

My eyes look angry/tired and slant down too much: what can be done?

You have mild ptosis (drooping) of the eyelids and it is noticeable laterally (the outside portion).  Also your lower eyelids slant downward slightly at the outside corners.  These can be addressed, but they are also variations of normal that eyelid surgeons see in their practices each day.  An in person-consultation would be optimal to go over your concerns if you wanted to have this addressed.  Botox can help the eyes not become as narrow when you smile, but not completely.  Hooding of skin can be conservatively removed and the outside corners of the lower eyelids can be raised by a canthopexy technique.  The eyes can be made to open wider by subtle ptosis surgery of the levator tendon that raises your eyes, but caution is advised as you don't want to undergo radical changes as you will no longer be the "you" that your friends have always known.  I would advise caution on proceeding surgically, but if you do want to consult with a plastic surgeon be sure they are very experienced with eyelids.  Oculoplastic surgeons primarily perform eyelid surgery in their practices, and often are the best for the concerns you have.  However, many other plastic surgeons are excellent at eyelid surgery as well, so find a surgeon with a great reputation.  Best regards.

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

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.