How can my eyes become more open and upturned? (Photos)

Question

My eyes are sad looking and look like they are sinking . What can I do to make them look more alive and neutral or slightly upturned ? I dont't want it to look fake like the cat eyes I see online , I simply want them to look naturally lifted and open. Why are they this way ? Are my cheeks also flat? Do I need both a ptosis correction and an upper blepharoplasty ? Would cheek filler or cheek lift or an infraorbital implant be necessary ? Canthoplasty or canthopexy ?

Frank Agullo, MD · Answer

Here is what is going on, with three things to fix. The pic shows upper eyelid hooding, a flattened lid-cheek junction that has drooped, and the outer corner being neutral or a bit downturned. That flatness you mentioned is the sinking. I cannot see a lot of ptosis in the pics that covers up the pupil and would mean you need a ptosis correction right off the bat, but a doc can check that in person and see if you need it. In terms of getting rid of hooding, a small and minimal upper blepharoplasty takes off the hood. For a smooth curve upwards at the corner, rather than the pulled cat eye effect that you want to stay clear of, a canthopexy will get you there, a gentle lift at the outer corner. The "alive" part is the lower eyelid and midface, where I see you are losing some volume on the rim of the socket and lid-cheek junction. Lifting the cheek before considering an implant would get nice support back there and your midface would push up on that. Filler or fat could also give you a bit of that. So I would be looking at a minor upper bleph, a canthopexy, and filler in the lower eyelid to restore the rim support and lift that flat valley you are referring to.

#StayBeautiful,

@RealDrWorldWide

#StayBeautiful,

@RealDrWorldWide

Kadir Berat Oyur, MD · Answer

Based on the photos, you appear to have mild upper eyelid heaviness, some degree of under-eye hollowing, and a slightly downturned lateral eye shape, which can create a tired or sad appearance. A combination of procedures may be considered depending on your examination findings, including ptosis correction if eyelid position is low, conservative upper blepharoplasty if excess skin is present, and volume restoration to the midface or tear trough area. I do not see an obvious need for aggressive procedures such as infraorbital implants. A subtle canthopexy may be beneficial in selected cases, but the best approach would depend on eyelid function, eye position, and facial anatomy during an in-person evaluation by an oculoplastic surgeon.

Eric Chang, MD · Answer

Your instinct to avoid the exaggerated cat-eye look is the right one, and the good news is that a natural, lifted result is very achievable. The tired and downward appearance you’re describing is typically caused by more than one thing happening at once, which is why the answer usually involves more than one solution.

From your photos, the contributing factors appear to include upper eyelid hooding from excess skin, a slightly downturned outer corner and some volume loss at the lid-cheek junction and tear trough.

A conservative upper blepharoplasty can remove the hooding without touching the corner shape. To address the downturned lateral corner, a canthopexy can create a more neutral or gently upturned angle without the extreme appearance you want to avoid. It’s a much more measured intervention than a canthoplasty, which is a more significant structural alteration. For the hollowness at the lid-cheek junction, volume restoration through filler or fat grafting can rebuild that transition and lift the area from below.

An in-person consultation with a board-certified plastic surgeon who specializes in periorbital surgery is the best next step moving forward.

Julian De Silva, MD · Answer

Thank you for the photos, and for being clear that you want a natural lift rather than a fake, over-pulled cat eye. That is the right instinct. An eye looks open and lifted because of several layers working together, so the honest answer is that no single procedure is automatically the one for you. In my opinion the questions to settle in person, in order, are: is the upper lid itself heavy or slightly drooping (termed ptosis), is the brow sitting low, and is there flatness or loss of support in the cheek and lower orbital rim that lets the eye look hollow and sad. Cheek support, whether by a measured amount of filler or a lift, can genuinely make eyes look more awake when the midface is flat. A canthopexy gently supports the corner and is far more natural than an aggressive canthoplasty, which is what creates the unnatural look you are keen to avoid. The art is doing the least in the right layer. This really needs an in-person assessment so the plan matches your anatomy rather than a trend. Best of luck

Michael McCracken, MD · Answer

Your primary issue is ptosis of both upper lids.  In the office, an eyelid specialist can put a drop in your eyes to temporarily tighten your upper lid lifting muscle so that you can see what a ptosis repair would do for you.  If you feel there is extra skin with the drop in, then you could add an upper blepharoplasty.
The outside corners do seem a little bit low.  If there is not a skin shortage (which you could have with or without a prior history of lower lid surgery), the corners could be lifted with a canthoplasty.  If there is a skin shortage you may benefit from a midface lift.  As for cheek volume, there is a small defecit.  I find the most straightforward fix for this is fat grafting to the cheeks.  
Due to your ptosis, I recommend you seek out an eyelid specialist (preferably a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery).  You can find one near you at the website asoprs dot org.

How can my eyes become more open and upturned? (Photos)

Answers (5)

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