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Treatment for Sunken and Hollow Eyes?

I have a sunken eyes with a shortage of upper eyelid fat. It's genetic and that's what gives me a tired and elderly look. What is the best treatment for this? A fat grafting surgery? Or a fat injection? Pease help. I'm a 28 year old (female) and my problem isn't the extra upper eyelid fat as most people had but the opposite, a shortage of an upper eyelid fat.

Doctor Answers 41

Open fat grafting is the best correction for hollow eyes

Dear Shaha,

I am sure many doctors will suggest fat injection or filler injection to correct your hollow eyes.

I strongly urge you not to have injections done into your upper eyelid. There are many very delicate structures in the upper eyelid which can be injured by a needle used for injection, and injury to the levator muscle could give you a droopy eyelid.

The safest and most effective method to plump a hollow upper eyelid, in my opinion, is an open composit fat graft.

During this procedure, I harvest a small amount of fat from around your "belly button" , make a small laser incision in the upper eyelid, and graft the fat directly into the hollow area of your upper eyelid.

This procedure works very well, has been done for many years, and will give you the best result.

Again, avoid injections in this area-it sounds so easy and simple, but the risks are not worth the possible benefit, in my opinion.

Fat on upper lids is not a great idea!

Although I have vast experience with fat transfer in the lower lids, I am not a fan of fat injections in the upper lids for your problems. The fat may make you lumpy and most importantly the excess weight can affect the muscle from working naturally. Although plastic surgeons love to provide answers for all problems, this may be a case of leaving well enough alone.

Robert M. Freund, MD
New York Plastic Surgeon
5.0 out of 5 stars 25 reviews

Fat Grafting


Fat Grafting is likely the best option for you. The synthetic products are also a possibility, however, I feel you will get the most natural result with your own fat. Just make sure you go to someone with extensive experience with fat grafting. Good luck

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 64 reviews

Fat grafting is excellent for sunken eyes

This is one of the areas that fat grafting really shines. Fat harvested from another part of your body and then reinjected along the upper orbital rim can have very dramatic results. It is usually permanent and has a very high satisfaction rate. If you're not sure, try some Restylane first, it's temporary and reversible.

Robert M. Jensen, MD
Medford Plastic Surgeon
5.0 out of 5 stars 27 reviews

Fat transfer around the eyes.

Facial fat transfer has great potential if done correctly.

That said, the procedure has many limitations and is not always predictable.

In general, facial fat transfer works best to give an overall volume enhancement in areas that have a substantial base of tissue in which to graft.

The areas around the eyes can be thin and have the potential of leaving irregular contours, lumpiness and other undesirable results when treated with fat grafting.

That is not to say the procedure is inappropriate.

It is a technique that requires diligence, experience and careful patient selection.

I suggest you consult with an experienced, board-certified plastic surgeon to find out your options.

Best of luck,

Mats Hagstrom, M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 9 reviews

Fat Grafting Effective for Sunken Eyes

Fat grafting can be very helpful for treating sunken hollow eyes, whether from genetics, trauma, or previous surgery. It can be done with a fine cannula and should not require surgery, but often more than one treatment is necessary because it is important to not add too much, and generally there is about 50% retention (50% of the added volume is lost within 4 to 6 weeks). What remains after that time should be relatively permanent. This may be a good option for you. Best wishes.

Fat transfer can blend the upper eyelid appearance.

What makes an upper eyelid look youthful is a natural transition from the eyebrow to the last line.  this region, in the most pleasing eyelids, have some volume and contour.  An aged or deformed eyelid has the appearance of being sunken and hollow.  A high crease of the lid makes this look even worse.  Fat transfer, fat injection or fat grafting (all the same description) is an excellent procedure to blend this area.  This is minimally invasive and very reliable.  This is one of the most common procedures I perform here in Southern California.

Hollow upper lids

Although there are a variety of opinions on this topic, my preference is for fillers here.  They are smooth, can be reversed if you don't like them, and are a little more predictable, results-wise,  than fat or open composite fat grafting.  

Treatment for Sunken Eyes

The optimal treatment non-surgically is a hyaluronic acid filler in the infrabrow hollow area done very discreetly. It is important not to over correct. If done as an operative procedure, it can be done with autologous fat by a Board Certified Plastic Surgeon with expertise in this area.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.