Why do my eyes look so old? (Photo)

You may benefit from conservative upper blepharoplasty and lower blepharoplasty but the technique is critical in achieving safe, natural results. Eyelid filler injection may also be another complimentary treatment.

Thank you for your photos and pictures. I would suggest a dual approach to correcting the eye area based on your concerns. I suggest an upper blepharoplasty to address the skin laxity on the upper eye lids. This is done through a small incision in the crease of the eyelid and allows me to remove the excess skin and probably small amount of fat. The scar is very thin and gradually fades over time. For the lower eyes I would suggest starting with a filler to fill the hollow space. That will give your eyes a less tired look and allow you to visualize yourself without those hollows. In the future you might benefit from a lower blepharoplasty which would remove the excess fat pads under the eyes. The upper blepharoplasty is done under local anestheisa and most patients use Tylenol for post op pain control. The under eye filler can be done at the same time as well. I would suggest going to see a board certified plastic surgeon. However, make sure your eyes are in their natural state with no allergic reactions for a few days so the surgeon can properly assess you. 

There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

The appearance of you upper eyelids could be greatly improved with a conservative laser blepharoplasty to remove some skin and possible a small amount of fat in the upper eyelids.

From the photos you're looking down mostly or closing your eyes which only gives us a chance to see  your skin quality.  You look as though you may have some ptosis and maybe some skin laxity.  A lot of it is just your skin quality.  Consult with an eyelid specialist and a dermatologist.  Also remember the way you've photographed yourself isn't the way people see you.  I"m sure your eyes are quite lovely.Chase Lay MD

This is a condition called blepharochalasis, by which the eyelid skin becomes lax with repeated episodes of swelling secondary to allergies. First and foremost, treating the cause of the allergies will be beneficial but will not necessarily address the resulting lax skin. A blepharoplasty to remove the crepey upper eyelid skin can improve your appearance to make you less tired looking. Fillers to the depression below the eyes, called the tear trough, can help ease the transition that you see where there is some hollowing and the appearance of "dark circles." You will want to find an oculoplastic surgeon, someone who is an eyelid expert, to assess you for both of these concerns and treat you accordingly.

There are numerous reasons for dark circles including:  Lack of fat in the hollow area called the tear trough, small blood vessels under the skin, congenital pigment in the skin, and shadowing from a combination of hills (fat pads) and depressions (tear troughs). Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: Botox or Dysport, temporary hyaluronic acid fillers like Restylane, long-lasting micro-fat grafts, light peels, lasers, blepharoplasties, or combinations of procedures. Each has benefits and drawbacks and depends on desired outcome and individual anatomy. A temporary filler would be a reasonable initial treatment. It can improve the cosmetic appearance of the eyes. The dark circles will be less obvious, but not totally eliminated. Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person. Robert Singer, MD FACS La Jolla, California