A: Treat the causes of the “tired eyes”
There are many reasons for the “tired eyes” look and it is important to understand the anatomy of the area first to decide how best to treat the area. In simple terms, the lower lid has skin, muscle, fat, septum, and the cheek area. A good examination of the area will reveal which or all of these factors are causing the “bags” and the tired look.
If it is minimal, sometimes a filler in the “groove” can smooth out the bags, and can be a “quick fix.” In younger patients, removing a moderate amount of fat through an “inside” incision (transconjunctival) can lead to a very natural result. In older patients, there is usually a combination of skin, muscle laxity, weak septum and bulging fat. This condition can be treated with a Lower Lid Blepharoplasty and Fat Transposition that will preserve more of the eyelid architecture for a more natural, long term solution. Make sure your board certified plastic surgeon examines the entire area and explains the pros/cons of the procedure in detail.