Would PRP permanently fix my hollow eyes? (Photos)

Question

I’m in my early 20s and have had hollow eyes almost my entire life. I’ve tried almost every non-surgical solution available, but none have been effective. I’m wondering if PRP injections could be a permanent solution, or if there are other options I should consider.

Ross Kopelman, DO · Answer

Hollow eyes (a tear trough hollow) are usually caused by a combination of bone structure, the way the fat pads under the eyes sit, and thin skin over the area. Because most of that is volume and anatomy, PRP is unlikely to be a permanent solution.
PRP can modestly improve skin quality, fine lines and sometimes pigmentation under the eyes by stimulating collagen. That may soften the look of the shadow, but it does not add meaningful volume, and the effect typically needs repeat sessions and fades over time.
The options that more directly treat hollows are hyaluronic acid filler placed by an experienced injector (results last roughly 9 to 18 months and are reversible), fat transfer for a longer-lasting result, and lower eyelid surgery with fat repositioning for the right candidate. The right choice depends on how much is hollow versus puffy, your skin thickness, and your goals.
Since this area is delicate, I would recommend a consultation with a facial plastic surgeon, oculoplastic surgeon or a dermatologist with a lot of under-eye experience, who can examine you in person. Hair restoration is my area of focus, so for the final call on the under-eye technique I would defer to those specialists.

Homeira Izadi, MD · Answer

The best option to treat the lack of volume under the eyes, is fat transfer which should be done by an expert surgeon otherwise it might cause bumps and lumps and worsening of the issue. The next and less invasive procedure can be either PRF or EZ gel. EZ gel is more effective but both procedures should be repeated and none is a permanent solution.

Hung William Song, MD · Answer

Under eye hollowness is tricky because this is a tight space where over treating can lead to long term complications. This is why PRP based treatments are great of under eye hollows and pigmentation. PRP, PRF, PBF gel, and EZ-Gel all work by signaling the natural production of collagen and fat. These regenerative treatments do require multiple applications and maintenance. Typically 2 to 3 treatments are required about 6 weeks apart followed by maintenance every 6 months. There are ways to prolong the signaling by embedding the PRP into a gel like the PBF gel which is created by heating the plasma. When PRP is embedded into a gel, and injected using the AutoCorre technique, we can usually get results with 1 or 2 treatments followed by yearly maintenance. If you want long lasting results, a fat transfer, when properly performed, will give you results that can last a lifetime.

Andrew Donohoe, MD · Answer

Thank you for submitting your question. This is such a common problem and I suspect many patients on this platform share your concern. PRP is a very good option for addressing under eye hollowness. It can help support the tissue and reduce darkening of the skin in this region as well. For significant deficits, PRP will often be done in a series of treatments to help provide the best correction (3 sessions, about 4-6 weeks apart). If you really need a lot of support in this area, it may be worth considering PRF Gel (often marketed as EZ Gel or Selphyl Gel) which is essentially PRP/PRF heated until it is more of a gel consistency. This makes it more of a volumizing agent. I would recommend this over using a filler in this area.
All that being said, your question was asking if PRP would be a permanent solution to this issue. Unfortunately, the honest answer is no. Since you are in your 20s and have a lot more aging in your future, your collagen and elastin will continue to degrade and your fat pads will continue to drift. PRP will help the issue, but it will require chronic maintenance as you age. Very little of what we have to offer in aesthetics should be considered "permanent" since the body continues to change over time no matter what we do (this include surgery).

Would PRP permanently fix my hollow eyes? (Photos)

Answers (4)

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