What can reduce the appearance of a negative vector eye & A-frame deformity? I don't want implants or injectable fillers.(photo)

Dear Suzie,Thank you for your question.  Obviously you have done some research into your situation as the terms you utilize are usually only used by surgeons experienced in eyelid rejuvenation.Your upper eyelids would respond well to fat grafting.  There really is no excisional procedure (such as skin, muscle or fat removal) that should be done as this would accentuate the volume loss of your upper eyelid region.  Fillers can be used, but I have found that fat works better in this region and the results can be permanent.  Fillers can be less predictable and need to be repeated, usually yearly.  Your lower lid really needs a lower lid blepharoplasty.  My approach is oribtal fat transposition across the infraorbital rim and a lower lid tightening procedure.  In some of your photos you do have some scleral show and the shape of your lower eyelid is too low laterally.  Tightening can be achieved by tightening the lateral canthus and the orbicularis muscle layer.  Usually some skin is removed just beneath the lashes using a skin pinch excision, which leaves no scar.  Sometimes the orbicularis retaining ligament needs to be released via the skin pinch incision.I perform these procedures regularly with consistent results an minimal complications.