Tired, sad appearing eyes seem to come to us all at some point.  You may even remember the first time when you noticed their transformation.  Perhaps it was after a good night’s sleep when a quick look in the mirror suggested you needed eight more hours, or perhaps it was how your eyes just looked “worn out” in a photo from a party or event, or it could have been the unsolicited comment of a co-worker asking if you were tired or sad, when you were in fact quite caffeinated or cheerful at the time.  Yes, tired and sad appearing eyes, for right or wrong, for better or worse can have an unsettling way of unintentionally communicating a wrong impression of ourselves, which study after study has shown can negatively affect your social, employment, and overall success in life.

There are ways to smooth those tired, sad appearing eyes and have them looking Refreshed.  The first step is to protect your eyelid skin from the sun, especially here in sunny Orange County, by investing in UV blocking sunscreens and sunglasses.  This is a quick and simple means to stop the sun’s UV rays from damaging the collagen and elastin fibers embedded within the eyelid skin.  The eyelid skin is quite thin and the UV damage can quickly and easily lead to loose, crepey skin.

Further means to rejuvenate and repair eyelid skin is with a good skin care regimen, which consists of good, medical-grade moisturizing eye creams and serums.  The ideal regimen should contain some important elements such as tretinoin (Retin-A is one form) or a retinol.  These important compounds have been shown to help re-build collagen and other factors associated with youthful skin.  Hydrating the skin is vital as well and products containing hyaluronic acids have shown consistent and balanced results.  But to build up the defensive strength of the eyelid skin add products to the regimen that contain anti-oxidants, such as vitamins C and E, Coenzyme-Q10, and herbal elements like green tea.

Although skin care products are valuable, there comes a point when a treatment must be considered because the aging process has progressed to a point where eye creams and products, no matter how good, just won’t smooth and correct those tired, sad appearing eyes.  For crepey skin, lasers such as the Active Fx fractional CO2 laser is the premier choice.  This laser can not only remove lines and wrinkles but tighten as well.  But if the skin is severely loose, surgical removal by a “pinch” technique may be the only true option to achieve the best result.

For those with eyelid and peri-orbital hollowing, fillers (Restylane, Belotero, and Juvederm for example) and fat augmentation, when performed by experienced plastic surgeons, can provide a robust return of youthful contours, leading to a refreshed look.

3 month result: fat augmentation, laser, skin care products5 year result (fat augmentation, laser, skin care products

6 months                                                                             5 years                                                    

(fat augmentation, laser, skin care products, by Dr. Miller)

However, the most noticeable tired and sad appearing eyes typically have eyelid bags.  Unfortunately, eyelid bags cannot be truly hidden by make-up or improved with creams.  The reason why is simple and fairly straightforward.  Eyelid bags are essentially a “hernia” of fat.  What is a hernia?  A hernia is, simplistically speaking, a pooching out of an anatomical structure that should not be pooching out.  The “fence” or barrier that was supposed to keep the structure inside has weakened through age or genetics.  In other words, as the fence weakens the fat pooches out creating an eyelid “bag”.

Knowing this is important and may save you money by not purchasing products that will have no effect on eyelid bags.  Just like you would not put a cream on an abdominal or groin hernia and expect it to work, the same can be said for an eye cream placed on an eyelid bag, because it’s a hernia!  Eyelid bags need a surgical correction, called a blepharoplasty (Bleph-A-row-plas-tea), and more information can be found about eyelid surgery, lasers, and skin care products by clicking here, or through an in-office consultation.

Timothy R. Miller, M.D.


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