Under eyes hollowing - what will be the right procedure for me ?

I am 27 years old and seem to be losing fat on face particularly under eyes and I can see smile lines creeping in as well. I would like to go for something permanent like fat transfer but I fear the possibility of its negative results. What would you suggest- fillers or fat transfer ? And how many syringes of filler would I need under eyes ? Also , do I need to do something with hollowing below my nose or this much hollowing is normal?

Doctor Answers 7

Fillers for under eye hollowing

It is difficult to answer this question without being able to evaluate a photo or seeing you in person. Fat transfer to the lower eye area is a much more involved procedure with more downtime and higher risk. As general recommendation of someone your age the Hyaluronic Acid fillers (Belotero Balance/ Restylane/Juvederm) would be the best for the hollowing and smile lines. One syringe should be more than enough to fill the area in question. These fillers are temporary so will need to be repeated, but in my opinion this can be a benefit in a younger patient as the face changes with age. If fine lines around the eyes are a concern this is best treated with a Botox product. Please be sure to consult with a surgeon who has ample experience with both and can evaluate your needs appropriately.

Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

Fillers, lasers, microneedling, fat all do well for this area. I suggest seeing an expert for an evaluation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

There is no question that hyaluronic acid fillers are far more predictable and infinitely more adjustable than grafted fat.

While the prospect of a treatment that lasts forever should so promising, grafted fat does not deliver on the promise.  I see 2 to 3 new consultation a week for individuals who need fat removed from their lower eyelid.  Also the midface and lower eyelid are glide planes.  Grafted fat scars these planes and this adversely affects how the face moves when you smile.  You will not like this.  On the other hand, hyaluronic acid fillers will last a year or more and causes no scaring.  If there is an issue with a hyaluronic acid filler treatment, it can easily be removed with enzyme.  Please be careful what you look for, you may find it.

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

Facial changes and lines at age 27

Thank you for asking about your facial lines and filler.

  • Without being able to see a photo, here is a general approach -
  • For lines around the eyes, Botox is the best answer by far.
  • For hollowing, Restylane filler can usually help.
  • Fat transfers are more expensive and have a significant recovery - start with fillers before doing more.
  • For the eyes, you should need no more than one syringe.
Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Under eye hollowing

It is difficult to assess the problem without photos but for general hollowing under the eye, a quick and simple solution would be to have hyaluronic acid fillers to these areas. It does not require surgery and is temporary in case you do not like the appearance. Most fillers come in 1cc aliqouts and that is usually more than enough for the eyelid areas. Fat transfer is a permanent solution that can benefit some patients but not ideal for all. It depends on your appearance and anatomy.  For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!

Johnson C. Lee MD
Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Filler under eyes

Thank your for your question.  Misspria without having an assessment, it is very hard to give you advice.  Many of my patients opt to have fillers under their eyes and find it a very beneficial temporary solution.  Please seek out a board certified plastic surgeon in your area with an expertise in facial/eye aesthetics and discuss treatment options.

All The Best! 

Hollowness and treatment

Thank you for sharing your questions. Without seeing you in person or evaluating photos, it is difficult to give proper guidance. Typically, 1cc of Restylane is more than enough to correct the tear troughs. See an experienced Oculoplastic Surgeon for comprehensive evaluation and discussion of treatment options.
Good luck,

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.