Why You Always Look Tired (It's Not Sleep — It's Your Face)

Under-eye hollowing is one of the primary contributors. The tear trough — the groove between the lower eyelid and cheek — deepens as the fat pad beneath it thins and descends with age. This creates a shadow that reads as dark circles even when there's no actual hyperpigmentation. The orbital bone beneath becomes more prominent as volume is lost, which emphasizes the hollow. Concealer covers discoloration but cannot fill a structural depression.

Brow descent is the other major factor. As the forehead and temporal fat pads lose volume and skin elasticity declines, the brow gradually drops. Even a few millimeters of descent can make the eye look heavier and more hooded, creating an expression that reads as tired or even stern. This is why some people notice they're asked if they're annoyed when they feel perfectly fine — the anatomy is doing the communicating.

The midface — the cheeks and the area beneath the eyes — provides the scaffolding that supports the lower face. When volume in this area diminishes, several things happen at once: the under-eye area looks more hollow, nasolabial folds deepen, and the lower face begins to look heavier relative to a flatter midface. The overall effect is an aged, fatigued appearance that is actually a geometric problem — a structural change — not a surface skin issue.

Many people try to address this with fillers placed directly in the tear trough, but the most effective approach often involves restoring the cheek volume that's supporting the whole area first. A skilled injector looks at the face as a whole structure, not as individual problem spots. Treating the midface often reduces the tear trough concern without touching the under-eye directly.

Hyaluronic acid filler in the tear trough and midface is the most direct treatment for volume-based tiredness. When placed correctly by an experienced provider, tear trough filler can dramatically reduce the shadowing effect under the eye. It's a technically demanding injection site and provider experience matters significantly here — it's worth asking specifically about their experience with this area.

For brow descent, a small amount of Botox in the right position can create a subtle brow lift by releasing the muscles that pull the brow down. This is a nuanced treatment — too much in the wrong place does the opposite — but in the right hands it can open up the eye area meaningfully. More significant descent may benefit from a thread lift or surgical consultation, depending on degree.