The “Tired Eyes” look is most commonly the result of at least one of three factors. Often it is the result of a combination of these factors:
– Loose and hanging skin around the eyes, medically known as blepharochalasis.
The skin around the eyes is some of the thinnest skin on the body. The advantage of thin skin is that it is the fastest to heal. The disadvantage is that it loses its elasticity faster than thicker skin. After one reaches their early 20’s the production of collagen comes to an end. At this point one begins to lose collagen and in turn the elasticity of skin. Sun exposure is the greatest contributor to the destruction of collagen. This is an accumulative effect, even though one may have used sunscreen on the face over the last 10 to 15 years. The damage from earlier sun exposure has already begun to take its course.
– Puffiness or bulging of the eye lids.
This can occur in both the upper as well as lower eye lids. Most often the bulging or puffiness of the upper lids occurs above the eyelid crease, on the inner aspects toward the nose. The bulging is known medically as “fat herniation”. The fat located around the eyes begins to droop down as one ages, causing the “tired” or “rundown” appearance. Genetics do play a role in how fast the fat herniation becomes apparent. One only has to look at the parent they most favor physically to determine if a fat herniation or bulging will occur sooner than later. And no, a diet or weight loss will not make the bulging disappear. Allergies do play a role in the puffiness around the eyes. If allergies are a key component contributing to the tired look, you should note the bulging decrease or disappear once the allergies are treated and the offending agents (pollen, animal dander, etc.) are removed.
– Raccoon eyes or hyperpigmentation
These dark circles around the eyes may be caused by several different factors ranging from heredity, allergies, eczema, medication, sun exposure or more serious conditions such as liver problems and anemia. Thinning of the skin around the eyes as one ages can cause the reddish – blue blood vessels under the eyes to become more visible. Medical treatment for the above conditions can improve the look of the eyes; however, if the conditions are due to sun exposure or increased melanin production (skin pigmentation) skin creams containing hydroquinone can help. I would caution against most over the counter hydroquinone creams. The strongest over-the-counter hydroquinone allowed by the FDA is 4%. Even at 4% most of these are buffered, which makes them less effective.
I have my own customized creams that a pharmaceutical compounding facility formulates for me. These creams range from 6% to 10% hydroquinone. They are much stronger and far more effective then the over the counter variety. The downside is one has to purchase this from a doctor’s office; however, they tend to be less expensive than some of the boutique brands, and last a lot longer because they are highly concentrated, a little does go a long way.
– Eye lid surgery (blepharoplasty)
Of all the plastic and/or cosmetic surgical procedures, eyelid surgery, or blepharoplasty, is the least tender and has the quickest recovery. Thinner skin heals much faster than thicker skin, and eyelid skin is some of the thinnest skin on the body. The down time from work generally depends on bruising. That’s to say, most individuals do not want to go to work with a visible bruise. Any upper lid bruises generally last 2 – 4 days while lower lid bruising may last 5 – 12 days. You may begin wearing eye make-up on day 5.
Most of our patients will take a pain pill the night of surgery, however only 15% or less of our patients will take pain medication the next day. One may shower normally the next day after seeing Dr. Marouk. If you are not taking pain medicine the day after surgery, you may begin driving. The eyes may be puffy for the first 3 – 5 days; however, they will not be swollen shut. Sutures are placed under the skin and generally dissolve between day 5 and day seven.
Please give our office a call to set up a complimentary consultation to further discuss this procedure. 480-814-1112.
Before and After Upper and Lower Blepharoplasty. Actual patient of Dr. Marouk’s. For more photos please visit our photo gallery.