What is the best filler for hollow upper eyelid?

Upper eyelid hollowness is a dramatically underappreciated, yet incredibly important component of aging in the eyelids. With normal aging, our upper eyelid fat pads tend to retract and expose this upper lid hollowness, those with “deep set eyes“ are especially prone, and unfortunately old-school upper eyelid surgery that is overly subtractive can artificially create this hollowness early, actually looking worse than it did before surgery - the before and after photo in the link below resulted from overly subtractive upper eyelid surgery with another surgeon, and you can see the results after revolumization of the upper lids. Correcting this hollowness can happen with fat or filler injections into very specific planes of the upper eyelid, or transposing and rearranging the upper eyelid fat pads to provide fullness, as you see in this surgeon’s view video, borrowing the excess fat to move into the areas lacking fullness!
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut
#realself100 Physician

I see patients aiming to improve upper eyelid hollows with some frequency.  The method of treatment depends on the reason for the hollowing and it depends on their goals.  An upper eyelid suclus as we call it, can arise from 1.eyelid ptosis (droopy upper eyelid with tendon disinsertion), 2. from normal anatomic variation, 3. from age-related changes, or 4.after an upper eyelid surgery in which fat was removed.  At least 9 out of 10 surgeons will suggest a hyaluronic filler (like a variation of Restylane or Juvederm) which works nicely when done properly (it is an off-label use of any filler).  There is also an option of using your own fat, which can last longer, but requires a surgeon that has a lot of experience with fat grafting and eyelid surgery.  My best advice is to find a surgeon with experience in this specific procedure and ask to see photographic examples to ensure this is the case.  See my web link below for one example.  

Fat is the preferred filler for hollow upper eyelids.  If you are not having fat injections then Restylane, a hyaluronic acid product, is probably the best choice to treat hollow upper eyelids.  Please be very conservative in this treatment as it is a fairly advanced injection technique.

I suggest going to a well trained filler expert who uses cannulas for injections and frequently does ocular rejuvenation with fillers, lasers, and skin care.

Thank you for your question. Although pictures would be helpful, in general I like injecting Restylane with a cannula (not a sharp needle) in this area. I particularly like Restylane Silk in this area. Please look for an expert injector as this is a very advanced injection technique and region. 

Fat grafting requires experience, expertise, meticulous technique and special instrumentation.  Start your search by viewing many many before and after images taken three, six and twelve months after surgery. When you find surgeons with work that is appealing to you, carefully check their credentials, education, training and safety record. 

Micro-fat injections is an effective treatment for upper eyelid hollowing.  Juvederm and Restylane are hyaluronic acid fillers that have been used in this area off label,  but would need to be done every 9-12 months.  The micro-fat injections should last longer than the hyaluronic acid fillers and can provide a very natural result.   I would recommend having a consultation to see what your best option would be to treat your hollow upper eyelids.

Thank you for your question. The hollowing above the eyes can be a very frustrating problem.
Thankfully there are great treatments available. Hyaluronic acid fillers such as Restylane and
Restylane Silk work well for this area. Please see an experienced injector for this advanced technique.

Hollow lids can sometimes be treated by using hyaluronic acid fillers. I prefer to use restyle around the eyes.  Best of luck