42 yr old female looking to address my aging eyes. What are my best options? (photos)

Hope this finds you well. To start you have beautiful eyes! Some options to make them pop even more could be upper lid blepharoplasty, possibly lower lid bleph, filler or fat transfer under the eyes and an annual laser resurfacing. Whoever you decide to go with make sure they have adequate experience with the eyes. Best of luck.

Your photographs are somewhat limited. However, it looks like you have excess upper eyelid skin and you may have some excess lower eyelid skin as well. You may benefit from an upper and lower blepharoplasty. You may also benefit from a brow lift. I would need photographs taken straight on and both side views to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best options for eyelid rejuvenation based on your pictures are a conservative upper eyelid blepharoplasty , laser skin resurfacing around the eyelids and consider some fillers with a fat transfer procedure.

Other non surgical options include laser skin resurfacing, Botox and injectables fillers such as the belotero you already had.