A frequent problem among the 45 and under group is looking tired, sad or even angry despite feeling fine. Friends are asking them, "Are you tired"? Eventually this question leaves people feeling frustrated. Multiple issues often come into play to cause the problem. Drooping eyebrow muscles (brow ptosis) and laxity of the upper eyelid skin (blepharochalasis) are two of the most common. Lower eyelid bags may further add to the problem.

Fortunately, this is a correctable situation. For the short term Botox can partially lift the brow and reduce frown lines and forehead wrinkles. A long-term solution can be achieved with a minimally invasive browlift along with upper and lower eyelid lifts (blepharoplasty). Often these results can last 15-20 years, especially in younger patients. The outcome is a refreshed and rested appearance along with relief from the old question, "Are you tired"?

Harold J. Kaplan, M.D., FACS
Diplomate, American Board of Facial Plastic Surgeons
Member, South Bay Independent Physicians Medical Group, Inc