Age 37, tired eyes. Blepharoplasty or forehead lift? (photo)

Dear doctors, please help decide what is the best, less extensive and expensive way to treat my tired-eyes-problem. i am 37 years old, have 2 children, meaning not enough sleep for the last 3 years. It made my eyes condition worse and by end of the day i have huge eye bags and top eyelids resting on my eyelashes. Dr recommended forehead lift and lower eyelids BF. What's the best way in your opinion? Will double eyelid BF and threads+occasional botox be enough or my Dr was right?

Doctor Answers 7

Brow lift and bleph

See an American board certified plastic surgeon.  You may benefit from a standard but conservative upper lid blepharoplasty .

Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Upper eyelids versus a brow lift

A brow lift is a fantastic operation when patients have low eyebrows.  The photograph shows a normal brow position, so a brow lift is not necessary. 
The primary goal of an upper eyelid blepharoplasty is to remove hooded skin touching the eyelashes. The incision is placed in the upper eyelid crease.
The primary goal of  lower eyelid  blepharoplasty surgery is to remove  a portion of the 3 fatty compartments on the lower lids creating the puffiness look.
For many examples, please see the link below to our eyelid surgery  photo  gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Tired eyes- blepharoplasty or forehead lift?

A combination of blepharoplasty with a brow lift can improve the eyebrow positions and appearance of the upper lids. Consult with a board certified surgeon with expertise in these procedures. Your surgeon can evaluate your eyes and demonstrate to you what could work best for you.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Tired Eyes

Based upon the photo you would probably do just fine with an upper eyelid skin excision and probably some fat removal - what is known as a blepharoplasty. This is a relatively straightforward operation lasting less than an hour. You have a crease extending outside the outer part of the lid and it may be necessary to extend the incision just a little bit further to remove this. An exam would settle just how much forehead relaxation is or isn't contributing to your appearance. Best of Luck    Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Blepharoplasty or forehead lift?

It is somewhat difficult to assess your lower eyelid area in the photograph (not standardized lighting) but some recommendations can be made with regards to your upper eyelids and eyebrow areas, although a better assessment and recommendation(s) can be made in an in-person consultation with a facial plastic surgeon.

The eyebrow position is excellent if your eyebrows are in the relaxed position and if no Botox has been recently injected.  I would guess that if you looked at photographs of your eyebrow position 10 to 15 years ago that they would be at a similar height. (See the link below for more information on brow position as we age.)  

Elevating your eyebrows would alter your appearance, and not in a good way, in my opinion.  It does appear you have excess skin in the upper eyelid area and a conservative removal of skin may be indicated, thereby providing a cleaner, refreshed look.   I would need to see the area up close to determine if fat augmentation and/or a lower blepharoplasty would be of benefit as well.

I hope this helps.

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Upper Eyelid Blepharoplasty for Tired Eyes

Dear Aliko~

Thank you for sharing your photo. It looks as if your brows are in good position and I would not recommend a brow lift based upon that one photograph. You do have a small amount of redundant skin, particularly towards the outsides of your eyes, and this skin is partially covering your upper eyelid crease (double eyelid). In an upper eyelid blepharoplasty the excess skin would be removed, which would help bring out your upper eyelid creases.

The other thing that you may consider is having some filler placed under your eyes. You have a slight hollowness in the under-eye area next to your nose, and a hyaluronic acid filler in this area such as Restylane could really help smooth the transition from your cheek to your lower eyelid, making you look brighter and less tired.  Fillers can last 9 or longer months in this area, and they can also be removed if you are unhappy with the appearance.

You have very beautiful eyes and I would not recommend anything dramatic. A subtle procedure would help draw attention away from the “tired” aspects of your eyes and bring out their natural qualities.

Best wishes,
Amy Hsu

Amy K. Hsu, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tired of people saying I look tired

I get lots of people who come to my office saying "I'm tired of people saying I look tired." Your eyes could be fixed with a bilateral upper blepharoplasty  (Eyelid lift) . I do these in my office regularly under local or sedation. The procedure takes about one hour, plus 30-45 minutes before and afterwards for the whole appointment. This would be the most efficient and permanent course of action to address your problem.

If you would like to try a more conservative approach you could start with botox around your "crow's feet" to help lift and brighten your eyes. Botox does not give as much of a result and only lasts 3-4 months. Hope you find this information helpful. 

Navin K. Singh, MD
Washington DC Plastic Surgeon
4.8 out of 5 stars 36 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.