Help? 53, not aging well.Upper and lower belepharoplasty? Bad underbite makes me look angry. Skin needs resurfacing. (photo)

I'm so unhappy with my appearance. My eyes make my look tired all the time. Deep circles and a sagging eyelid. I had a rhinoplasty that left me with a drooping tip. My jaw looks weak and my mouth has strong downward lines that make me look unapologetic and angry. Thin upper lips. Skin showing years of too much sun. I hate looking like this and really need some professional guidance as to what I could have improved in my facial features. Thank you!

Doctor Answers 7

The anger is not in the face.

You have upper eyelid ptosis and this needs to be corrected with the blepharoplasty.  Doing a blepharoplasty without correcting the upper eyelid ptosis will not be helpful.  It is not about the little bit of hooding you have.  The lower eyelids are probably best addressed with a chemical peel in my opinion.  Try not to have the blue plate special.  Don't punish yourself with surgery.  Less is more.  Shop carefully for your cosmetic surgeon.

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Eyelid rejuvenation along with facial rejuvenation

There are a lot of things that we can present to you to maximize  your facial rejuvenation:1. Eyelid ptosis repair2. Brow lift with fat grafting3. Blepharoplasty4. Face/neck lift5. Revision rhinoplastyAll these procedures can improve and rejuvenate. The true questions is which procedures are right for YOU. Unless you sit down with an experienced surgeon that actually listens to your concerns, its impossible for us to give you a recommendation that is right for you! Sit down with a couple of surgeons and have them listen to you, and then provide you with their approach to help you look and feel better. Once you have done that, you can decide which surgeon bests matches your needs.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 30 reviews

Helping with a tired look

Thanks for sending in your photos. There are some simple non surgical things you can do to improve your skin and fine lines. Halo skin resurfacing, careful use of Botox. etc.

As for your eyelids you do have some ptosis in addition to some excess upper eyelid skin and this would require surgery to repair.

Your nose has drooped a little and this is probably correctable depending on the details of your previous surgery.

Have  a thorough consultation with a reputable practice that can offer you a wide variety of options.

Good luck!

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Transforming the tired look...

I know you are hearing many opinions... but here is an office approach which minimizes surgery and down time:  Direct brow lift (incision next to brow hairs, shaped carefully to avoid high arch), midface/ cheek filler with Juvederm Voluma (helps with the tear trough), MiXto CO2 laser resurfacing including the lower lids, filler in lips from posterior approach, and maybe some micropigmentation later to enhance the brows, define the eyelids, and/or lips (or just makeup). Many surgeons shy away from the direct brow lift, but carefully done, it may produce fantastic results with a relatively easy recovery - might have to use a little makeup on the incision lines while the incisions fade.The combination of filler and laser is great for the lower lids particularly when there is not an abundance of prolapsing fat. Most of this could be done at the same time. The MiXto patented handpiece allows superb control of the energy delivered and takes care of sun damage, fine wrinkles, and large pores - and tightens the skin (not as much as a facelift of course - but very satisfying to patients). It is fractional and can be done very comfortably with Xanax pre-treatment, topical anesthetic, and nerve blocks in the office. You have very nice features that will respond well to minimally invasive treatments - and a great smile! Best wishes with your decisions! 

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Upper and lower eyelid surgery candidate

 The primary goal of upper eyelid surgery is to remove excess and hooded skin which is  folded over upon itself creating the tired look. A small amount of fat is also removed as well. The primary goal for lower eye lid surgery is to reduce the puffy look by removal of fatty deposits through an incision on the inside of the lower lid. If there is excess skin present, a small pinch of excess skin is also performed. In our  practice the lower lid incision is closed with tissue glue. For many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Brow lift and lower blepharoplasty for sad aged eyes.

Brow lift and lower blepharoplasty for sad aged eyes will greatly improve your appearance. If you have this done it is best done in my opinion with the Irregular Trichophytjc Incision where3 the hair grows thru the scar so it is not noticeable. Look at the surgeons results with the hairline etc.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Aging face

You have a lot of issues that concern you and a lot of options for rejuvenation.  You have a ptosis which is worse on on the right side, and extra skin on the left. Brow is a little low laterally.  Lower lids could use some laser and fillers, or a blepharoplasty.  For jowls and neck a face/neck lift.  Possible chin implant and revision on the nose.  Lip filler.  
Get a few consults and decide what you feel comfortable doing, and who you would like to do it with. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 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.