I have noticed my eyes are becoming increasingly hollow and boney looking. Wanting to address this. Filler or fat transfer?

Question

I have had my tear troughs filled in the past with good results but it is no longer enough. I look so tired all the time. My eyes have become noticeably uneven too with more fat loss to the right upper lid and brow then the left.

Jason Emer, MD · Answer

fillers, fat and eye surgery (eye socket surgery) can help you get an improved look.  at home you should start treating the skin as well to brighten the area.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now.

There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term.  There are many things you can do to treat under eye hollows and dark circles without surgery.  Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture.  I suggest you get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Ali Riza Öreroglu, MD · Answer

Volume in the face can be restored with both the use of fillers and fat grafting. You may want to have a try with fillers first as they are more temporary and see how you like it. You can move on to fat grafting later on. It will be best to consult a board certified facial plastic surgeon in person and discuss your goals and options after a physical examination.

Patrick Flaharty, MD FAACS · Answer

Fat transfer works great to restore lost volume in the upper eyelid - brow region as well as the rest of the face. As fat transfer is a surgical procedure you want to make the most of that opportunity. For that reason we typically do full face fat augmentation all at one time to address the entire face in one procedure. This will include the upper and lower eyelids and also includes the temples, cheeks, jaw line, perioral region and lips. Full face fat augmentation is really a global volume restoration of the entire face and works best when done as a comprehensive volume restoration procedure.

Mats Hagstrom, MD (license on probation) · Answer

You are developing enophthalmos.

This can be restored by decreasing the intra-orbital space.

To do this I suggest having a few ocular plastic surgery consultations.

This would not necessarily be treated with fillers or fat transfer.

By decreasing the eye socket size your eye will be pushed forward.

Best,

Mats Hagstrom MD

I have noticed my eyes are becoming increasingly hollow and boney looking. Wanting to address this. Filler or fat transfer?

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