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I recommend you upper and lower blepharoplasty. This will be ideal for you due to collection of excess skin on your upper eyelid and lower eyelid as well. The fat is creating what we call a hooding effect over your eyes which is giving ou a tired look.
Thank you for your photos! I would need to examine you to best answer your question, but from your photos and what you describe, you may be a good candidate for eyelid surgery. Eyelid surgery has become one of my most popular procedures. If excess upper eyelid skin is hooding the eye and needs to be eliminated, an incision is made in the crease at the top of the lid and excess fat (if needed) and skin are removed. The incisions are closed and sutured on the underside of the skin. The lower eyelid can be improved through a hidden incision making it scarless! This can help address excess fat causing eye bags. I performed eyelid surgery in my fully-accredited operating room. I suggest making an appointment with a board-certified plastic surgeon to discuss your options.
The upper eyelid appears to have excess skin. A facial plastic surgeon would perform an in person physical examination to confirm. If that is the case, then upper blepharoplasty (removal of the excess skin) would be the best procedure to treat this (would provide the best improvement). The recovery is commonly easy. Other options that would give partial improvement include radiofrequency microneedling (such as Matrix RF or Morpheus8) or fractionated erbium YAG laser (such as Sciton profractional). If you decide on a laser treatment, make sure to go to a provider with experience treating patients with pigment in their skin. Because your skin has pigment, fully ablative skin resurfacing laser would cause burns so it is not recommended.
A lower blepharoplasty with fat transfer to the cheek to support the lower lid is a nice option based on your photos and goals
Yes, on the side with the vertical blinds in the background, there is a slight negative canthal tilt. It is neutral on the other side. A canthopexy improves this
Except Sallows is best assessed by an ophthalmologist. The confirmed diagnosis requires certain measurements. I suggest seeing an ophthalmologist in your community. It’s possible an optometrist may be able to do a simple assessment, but I think you’re better off getting the care of an oph...