I'm 20 years old and have a case of hollow sunken eyes. Can I improve this without surgery? (Photo)

Question

Im around 12kgs underweight and i feel this may a reason for them along with my low water intake.Can i improve this by putting on weight and changing my eating habits for the better?Without surgery!

Kian Karimi, MD, FACS · Answer

Thank you for sharing your question and photos. First and foremost, please ensure your weight is being properly managed by your primary care physician. Once the source of your weight loss has been identified and you return to a healthy weight for your height, you can consider cosmetic injectables. You appear to be an excellent candidate for dermal fillers to the under-eye area. In my practice, I like to use Restylane in this area to restore lost volume and make you appear well rested. I prefer to inject filler to the under-eye area using the microcannula technique, which is essentially bruise-less and provides a very natural, even looking result. Given your unique circumstances, an in-person evaluation is necessary in order to get more specific recommendations. Please see a board-certified specialist once you have reached your goal weight. Best of luck!

Mehryar (Ray) Taban, MD, FACS · Answer

Yes, you can have treatment of under eye hollowness with filler injection. See following video and link for more details. The filler should last 1+ year.

Jason Emer, MD · Answer

Good diet and exercise can help improve appearance. Fillers, lasers, and microneedling/PRP can also improve under eye hollows. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

David C. Mabrie, MD · Answer

Hi shiv13,Weight loss can cause under eye hollows but luckily there are a non-surgical options to improve these hollows. Dermal fillers are now the gold standard for treating hollow sunken eyes. In my practice in San Francisco I would treat a case like yours with a combination of Juvederm Voluma to the mid-face and Restylane to directly under the eyes. Both fillers are hyaluronic acid fillers. They are clear gels which may be reversed with an injectable enzyme. Juvederm Voluma is a thicker filler, strong enough to fill the mid-face with a soft feel, and can last up to 2 years but can be reversed at any time.Restylane is a thinner dermal filler more appropriate for tear trough treatment. Results initially last 6-12 months but last longer with consecutive treatment because the fillers stimulate collagen production.Two caveats you should know about:
  
1. Find someone who specializes in under
 eye treatment, as this is an advanced injection technique that requires
 specialized skill and finesse. 
  
2. Patience is required. It may take 2 or 3 injections to get your optimal result.

Good luck in finding your solution!

Daniel J. Ritacca, MD · Answer

Thank you for your question. There are non surgical approaches that can help restore volume such as injectable fillers. I would seek an in person consultation with an expert to determine your candidacy. Best wishes.

Camille Cash, MD · Answer

It is important to address your weight first before considering other options.  A healthy weight will affect how you look and feel.  If after that time you are still concerned about hollowness you can consider non surgical options such as the use of fillers to add volume.

David Q. Santos, MD · Answer

Of top priority is to get healthy and to reach your ideal regular diet, ideal weight, regular exercise routine, and regular routine sleep.  Get yourself healthy first, then look to work to improve your eye aesthetic appearance later.  The first option for periorbital rejuvenation would be to try fillers particularly to the lower periorbital region.  Later try fat transfer to hollow areas.  Overall take this on in stepwise fashion, don't be in a hurry, consult good physicians, and realize surgical options such as blepharoplasty are not presently warranted.

John McCann, MD, PhD · Answer

Hi Shiv13,

Thanks for your question and photo. Looking at your picture, I can appreciate some atrophy of the fat in your orbit (eye socket) cause a hollow, sunken appearance. This can certainly be related to weight loss and will improve with the addition of more body fat. The dark circles under your eyes may also respond nicely to injection of HA filler.

If you are considerably undeweight, I would recommend a program to gain weight. A consultation with a skilled oculoplastic surgeon in your area could also be of benefit. Thanks!

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