LAM FACIAL PLASTICS

I am a 54 year old woman who had a blepharoplasty on both my upper and lower lids back in 1996.

My lower lids have a slight heaviness but are pretty hollow in the tear trough area. I especially see the contrast when I wake up in the morning and my lower lids are puffy except for the tear trough area. I have always had puffy eyes when I wake up in the morning. I went to 3 plastic surgeons for a consultation. The 1st surgeon said she wouldn't take away any fat from the lower lids but would use a filler in the tear trough area. The 2nd surgeon said he would not take away any fat but reposition the fat to fill in the tear trough area. The 3rd surgeon said he would take away some fat from the lower lids and wait till they heal to see if I need filler in the tear trough area.

I also have heaviness in my upper lids but did not discuss my upper lids at the time of my consultations. I am wondering whether I would be a could candidate for a browlift, upperlid blepharoplasty, botox or a combination of these options. Any feedback will be greatly appreciated. I have attached photos.
Thanks.

hi,
you appear to be a good candidate for a fat transfer to reframe your eyes. although your eyes may appear heavy to you, they are just emptied out. i believe the quality of a fat transfer is not just filling one little area but doing multiple small areas to create the most balanced result including in your case: brow, upper eyelid, lower eyelid, temple, anterior cheek, subzygoma laterally (outside under the cheek bone), anterior chin, prejowl (in front of the jowl). your buccal area looks full and most likely i would not put anything there. in short, doing multiple small areas can help make the face look more balanced and youthful. hope that helps as a start to understand my philosophy.
best,
sml