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Treatment for Sunken and Hollow Eyes?

asked 3 years ago by shaha in saudi arabia
Latest answer by Larry S. Nichter, MD, MS
Question viewed 36,118 times
Tags: age 25-34, eye hollows, female, sunken

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.

23 answers to Treatment for Sunken and Hollow Eyes?

+15

Fat Grafting for the Upper Eyelid Filling Hollow Eyelids with Fat Grafting, Fat Transfer

Fat graft the upper lid? No. Add fat to the brow-upper lid junction? Absolutely. This is an excellent question, and I think the wide range of answers is in part an issue of terminology. The upper eyelid is a thin structure that normally does not contain any significant amount of subcutaneous fat. So fat grafting of the upper eyelid itself would not produce an aesthetically pleasing result, and would in fact be quite dangerous to attempt. The area between the... more

Michael Law, MD
Raleigh-Durham Plastic Surgeon

michaellawmd.com

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... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

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

Fat Grafting

Shaha, 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

www.ShaferPlasticSurgery.com

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

Sunken appearing lids

Thank you for the question. I will refer to the photo you provided. In general, fullness around the eyelids is youthful. Two minimally invasive ways to improve fullness around the eyes are fillers or fat injections. Fillers (non-permanent types) can be a safe way to "test the waters", so to speak, to see if the results are appropriate and appealing. If so, you can then consider having fat injected (which is more permanent). If you do not like the effect of the fillers, then with... more

Farzad R Nahai, MD
Atlanta Plastic Surgeon

Can Hollow Upper Lids be improved

Fat transfer to the upper lids is a subject that is discussed and reported at increasing frequency at our Plastic Surgical Meetings. I believe it to be a very helpful technique if done by skilled surgeons with experience doing this. It is probably safest to directly place the fat the at where needed than blindly by lipoinjection with a micro cannula. Seek an experienced board certified Plastic surgeon, Oculoplastic surgeon or facial aesthetic surgeon who has substantial... more

Larry S. Nichter, MD, MS
Orange County Plastic Surgeon

drnichter.com

Fat Grafting to Improve Hollow Upper Lids

Certainly, improvement of upper lid hollowness can be achieved with facial fat grafting. Therefore, I like fat injections for this particular problem. Of utmost imprtance, of course, is placing the right amount in the right places. Without a thorough understanding of anatomy and esthetic goals, no cosmetic surgery will be successful.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

Hollow upper lids.

Tricky problem - one for which there is no easy answer. Hollow upper lids results from a lack of fatty volume in that area. Somehow, you need more volume there. My partners and I have dealt with this issue for years and, sadly, we now know what's more "not" the answer than what is. How to get volume in that delicate area is not straightforward. Fat grafting seems like the answer, but can become lumpy and problematic. Juvederm works... more

Robert Sigal, MD
Reston Plastic Surgeon

Fat transfer can be used for sunken eyes...

Fat transfer is a procedure where fat is lipo-suctioned out of your thigh area then processed to be used in other areas. Many patients use this fat to inject to their nasolabial folds, however, it may also be used to soften the appearance of hollow or sunken eyes. Fat is not normally used in the upper lids, because the skin is too thin. You should speak to your surgeon to see if you are a candidate for this procedure.

Andrew Miller, MD
Edison Facial Plastic Surgeon

Microfat grafting is safer

Dear lady, fat grafting is a very good treatment for sunken eyes and tear troughs. It is very important that a correct technique is used. Initial reports of fat grafting mention lumpiness and overcorrection. If the fat is harvested with microperforated canulas it will have a very delicate structure and will allow very precise delivery in the required area by multiple passes with a 0.9 or 0.7 mm canula. If the fat is deposited deeply and fanned out evenly the chances of... more

Alexis Verpaele, MD
Belgium Plastic Surgeon

Fat grafting to the mid face and peri-orbital region

In general, fat grafting to the malar (cheek bone) area, and the bony region around the top of your eye can help soften the 'sunken' look that you describe. Its especially effective in patients with otherwise good skin quality.

Scott Sattler, MD
Bellevue Plastic Surgeon

Fat n the eyelids

Transfer fat in the eyelids is a good possibility, better off to leave a pedicle if possible for better blood supply. Sometimes juviderm or restylene in the lower eyelids is and rapid application and real if of sintoms with one inyeccion

Alejandro J. Quiroz, M.D.
Mexico Plastic Surgeon

Sunken hollow eyes

This is not a simple question to answer. You really need to be evaluated for this concern. If you are sunken in, was there trauma causing this? Have you had previous surgery? Fat injections to the upper eyelid region may help this area if it is just a cosmetic issue.

Steven Wallach, MD
Manhattan Plastic Surgeon

Sunken eyes

First, you have to dignose the reason for the sunken eyes or hollow eye syndrome. It can be a function of boney structure, or deep set eyes due to lack of fat around the orbit, or the lack of fat around the eyelids. If it is due to lack of fat in the eyelids then micro fat transfer is the best treatment. You are confused because we are not able to examine you and give you a definate answer. Good luck.

Samir Shureih, MD
Baltimore Plastic Surgeon

Fat injections or fat grafting can be performed for sunken and hollow eyes

Fat injections or fat grafting can be performed for sunken and hollow eyes. However, it has to be done in the appropriate fashion so that it does not give the appearance of a lumpiness in the orbital area. It also has to be placed deep into the eyelid area so as not to be seen as lumpiness.

William Portuese, MD
Seattle Facial Plastic Surgeon

Filling the Upper Eyelid Sulcus

Shaha, Based on your age and depth of the upper lid sulcus, I would recommend a very small amount of hyaluronic acid filler. This injection has to be placed very carefully by a trained plastic surgeon. It has been my experience that hyaluronic acid fillers in this location can last 12 to 18 months. Remember, start conservative; you will not be happy with too much filler. I would not recommend fat grafting as a first step in your case. As you grow older, if the problem worsens, then I would... more

Daniel Reichner, MD
Newport Beach Plastic Surgeon

Ptosis correction may improve hollowing

Shaha, You have a deep upper eyelid fold with a low or ptotic eyelid. This condition requires surgical correction. There are several procedures available and specific to your specific condition. The surgical correction of the ptosis may improve the hollowing. If not, fat grafting may be performed. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

You can fat graft the upper eyelid

I have often placed strips of fat grafts into the upper lids for this exact problem as well as for post-operative correction of over-resected upper lid fat. The best fat to use is from the lower eyelid if that is available. Fat injection is less reliable, I feel.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Fat injections will definitely help.

However they are tricky and should only be done by someone with a lot of experience. Also the level of your upper lid lashes is slightly low (this is called minimal ptosis). People with ptosis have a very deep fold. This can possibly be corrected surgically. You need to see an oculoplastic surgeon (eye surgeon who specializes in eyelids).

George J. Beraka, MD
Manhattan Plastic Surgeon

Correction of eyelid ptosis necessary

Based on the picture you have upper eyelid ptosis. This is a congenital condition. If you get a eye examination by a opthomologist you will have a visual field defect and usually these patient have a hard time seeing at night. You will need a ptosis repair and possible fat grafting.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Sunken eyes requires a special approach

Fat autografting this close to the eye has been associated with blindness and is highly technique dependent. I would highly recccomend someone who is highly skilled and experienced with either FAMI (fat autograft muscle injection) or the Sid Coleman technique. In terms of other dermal fillers, I believe the yield for predictable and natural results would be very low if injected this close to upper lid. Lower lid tear trough areas are much more predictable however. Dr. Malouf more

Peter Malouf, DO
Dallas Dermatologist

mytotalskincare.com

Fat grafting for sunken eyes

Hello shaha. Deep, skeletonised upper eye lids will give you a tired look and could also give an impression of aging. The only option avaialble is to use fat transfer to be able to fill the upper eye lids. Other fillers could be used as well (hyaluronic acide based). This is a very technical procedure and it has to be done very carefuly to avoid bumps in this area with very thin skin. A retrograde injection technique has to be done to avoid injection into a blood vessel which could lead to... more