The extra skin of her upper lids caused her to appear tired and unhappy, even though she has a very cheerful personality. You can see the strain in her eyebrows as she's using her forehead muscles in an attempt to pull those upper lids higher and open her eyes. Using Botox to relax the forehead would be a huge mistake as it would drop the brow and close her eyes even more! The solution here is to address the primary cause, which is mostly just excess upper lid skin. We did a simple skin excision upper blepharoplasty in the clinic under local anesthesia, but notice what a massive change that made - her eyes are more open, the brow/forehead strain is relaxed, and most importantly - her upper face no longer projects tiredness or stress and her personality can finally come through. The after photo was taken at ~3 months post-op, so the scars are still slightly visible, but they will soften and fade with time. When the incisions are designed correctly, the scars usually heal so well that they're essentially hidden from the naked eye even when you're looking for them.
(Nov 24, 2021)