57 Y/o F W/deep Dark Thin Hollowness Undereye Seeking Best Approach to Improve Appearance.

One doc says browlift, upper eyelids with only laser resurfacing of lower lids. Another recommends SOOF several years ago on consult. Posting photo....I know we can get improvement on upperlids, I HATE lower..makes me look sick..what can be done? I have no fat there, just thin skin.

Doctor Answers 4

Surgical correction for the upper and lower eyelids - Be

The best treatment for you is a surgical correction.  Some of your orbital fat can be used to fill in the hollowed out areas.  The muscle can be re-suspended laterally ant some of the malar cheek fat can be resuspended laterally as well.  This would be the best way to  get rid of the hollowness and make the dark circles less noticeable.  The darkness is due to the shadowing caused by the hollowness.

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Improving hollowness under the eyes

A brow lift is not necessary when the distance between the eyebrow to lash-line is of adequate distance.  The best option is an upper blepharoplasty, which can improve the hooded appearance of the upper lids.   There are several options for the lower lids.  While there is hollowness over the superior portion of the maxilla, there still is herniated fat from the orbital fat compartments, which can be very conservatively removed.  A pinch of excess skin can be taken at the lash line.  Small cheek implants are another option for increasing projection and youthfulness of the maxilla.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Restylane injections to tear troughs work very well.


1)  This is a difficult problem, and I don't recommend the suggestions made to you.  Surgery here can easily make you worse unless very expertly done.

2)  Restylane injected in tiny quantities deeply under the muscle can really improve the hollows under your eyes, and it lasts up to three years.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Tough stuff because of thin lower eyelid skin.

There is more than one way to do things and not necessarily a right or a wrong way.  Without a personal consultation it is hard to give you a concrete answer.  However, I suspect that you could do well will carefully performed fillers and possibly a lower eyelid/midface chemical peel.  I do recommend that you get several opinions because there is more than one way to help these issues.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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