What can be done about prominent, always tired-looking eyes? (Photo)

I think I always had these eyes. I'm 20 now. They always look bulging, tired, and ugly. Is there something that can be done to fix this?

Doctor Answers 2

Non-surgical treatments and lifestyle changes that can help tired-looking eyes before committing to surgery

As a specialist in facial aging and a cosmetic oculofacial plastic surgeon, I ask my patients if this appearance runs in the family to determine if there is a genetic cause. I also ask them about lifestyle that could be a cause: lack of sleep, smoking, or environmental factors such as sun exposure, a toxic environment or stress can affect appearance. One of the most common reasons people come to me is when their friends and coworkers have noticed their eye bags.

One thing that I noticed from your photo is there is a bit of a puffy area in the inner aspect of the lower eyelids. This is called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that is normally around your eyes slightly pushes forward and creates a bulge.

20-years0ldI have operated on a patient as young as 14 who had significant bags under their eyes. He became withdrawn from school because everybody thought he was on drugs, so his parents brought him in and we took care of the bags under the eyes.

During consultation, I ask if the eyes are puffy all the time, or if they have good and bad days. If there is variability on how puffy they look and the eyes are very puffy most of the time, then that’s a good time to consider a procedure such as a lower eyelid blepharoplasty. You can also consider some conservative methods such as topical creams that are good moisturizers and even things that are holistically good for you such as better diet, sleep and exercise.

If you feel that there are aspects that you just can’t deal with then consulting with qualified and experienced cosmetic surgeons will be a benefit. When you are getting opinions, remember that surgeries can’t easily be undone or reversed. Any decision is something you have to live with. Often we try conservative measures first such as topical creams or even injections like platelet-rich plasma and Restylane to help improve the appearance. The nice thing about these modalities is they are not permanent. If you don’t like them, they just disappear. If really want to do something that’s more definitive that’s beyond lifestyle changes, then explore these options. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Tired eyes; eyelid bags

Tired eyes are the result of bulges and dark skin of the lower eyelids.  Some patients as young as you are affected.
 These conditions can be improved with injection of fillers (fat and hyaluronic acids) with varying longevity of correction.
Removal of fat from the bags is a more permanent solution.
Please consult with a Board Certified Plastic Surgeon in person prior to making treatment decisions, cheers.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 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.