42, best options for the eyes? (Photos)

Dear Thrifty,

Looking at the photos and your concerns, here's a breakdown:

Upper Eyelids

Diagnosis: Dermatochalasis (excess upper eyelid skin) and early hooding.
Solution:
✅ Upper Blepharoplasty — This is the gold standard. It removes the excess skin and recontours the upper eyelid crease, helping you look refreshed but still natural.
Lower Eyelids

This area is more nuanced, but here's what I'm seeing:

Excess Fat/Bagging: Likely caused by herniated orbital fat pads.
Hyperdynamic Muscle: Smile-related bunching from active orbicularis oculi muscle—this can’t be surgically removed, but we can work around it.
Tear Trough Volume Loss: Creates the appearance of hollowing under the eyes.

Recommended Surgical Plan
Upper Blepharoplasty
To correct hooding and improve your overall expression.
Lower Eyelid Transconjunctival Blepharoplasty
To remove or reposition the fat pads from the inside of the lower eyelid (no visible scars).
Pinch Lower Blepharoplasty
To conservatively remove a small amount of loose lower lid skin without compromising eyelid support.
Fat Grafting or Hyaluronic Acid Filler (e.g., Restylane)
For subtle tear trough correction, usually performed after fat removal for optimal contour.

From the photos it appears you would be a good candidate for Botox. This can help minimize the full look under the eyes which is often referred to as "jelly rolls". Be sure to see an expert injector for this treatment.

The muscle that bulks up under the eyes when smiling is very normal. Many people have it. It's not really advisable to have surgery on it to "cut" some of it out, which could leave irregularities. Micro Botox injections usually work very well.