What is the best option to correct lack of volume in the lower eyelids? (photos)

Question

I think my lower eyelid area lacks volume and was wondering what would be the best way to improve this area? Would it be filler or a different treatment?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos—they really help illustrate the area you’re concerned about. Loss of volume in the lower eyelid, sometimes called “tear trough hollowing,” is a very common concern and can make the under-eye area look tired or shadowed.

The most effective approach is usually dermal filler:

Carefully placed filler can restore subtle volume, smooth the transition between the lower eyelid and cheek, and improve the appearance of shadows.

Precision is key in this area because the skin is thin and sensitive, so using the right type of filler in the right plane is essential for a natural, soft look.

Other supportive treatments:

Skin quality treatments such as microneedling, fractional laser, or radiofrequency can improve texture and firmness, helping the area look smoother.

Fat grafting is a more invasive option that some people choose for longer-lasting results, but fillers remain the most common first step.

For most people with under-eye volume loss, fillers provide a safe, effective, and natural-looking improvement. Combining this with treatments that enhance skin quality can further soften the area and reduce shadows.

Eric M. Joseph, MD · Answer

Since you appear to have a bit of scleral show, I would be hesitant to recommend lower eyelid blepharoplasty to remove the fat pads. Additionally, surgery could lead to a more hollowed appearance. In our practice, we utilize Silikon 1000, a permanent filler, to add a small amount of volume in between the lower eyelid bag and the cheek for a less hollowed appearance. I hope this helps. Sincerely, Dr. Joseph

Guler Gamze Eren, MD · Answer

You have a pretty good face, the length of lower eyelid is normal. I don't recommend you any fillers or fat transfers for your lower eyelid area. Lower eyelid area reduces volume with the aging process. You look young and don't need any additional volume right now.

Nelson Lee Novick, MD · Answer

For several years already there have been HA fillers made by various companies specifically for treatment of this area. In the hands of an experienced, board certified cosmetic dermatologist filler expert, treatment generally takes no more than ten to fifteen minutes to perform and the results are typically immediate, engenders little to no significant downtime, and evokes an immediate "Wow!" reaction. By contrast, blepharoplasty surgery tends to be extensive, engenders significant post-treatment downtime, and runs the risk of post-surgical scarring. And, if you are hawked some kind of "bells and whistles" fraxel laser or RF device treatment, exercise a hefty amount of "buyer beware," as the hard science to back up the use of these expensive gizmos lags well behind the heavy marketing and social media buzz to promote them. Hope this helps and best of luck.

Camille Cash, MD · Answer

HA fillers are a great option to improve hollowness under the eye and enhance overall contour.  The treatment is done in the office with some of the results seen immediately.  It is important to select and experienced injector for best results.  I've included a video that I hope you find helpful.

Darryl J. Blinski, MD · Answer

Based on your post of photos, either nano fat crafting under ultrasound, guided injections or 2 to 3 sessions of H A filler injections to the teardrop deformity. Expect fees to range from $2000-$5000. Best to virtual consult with.

Leonard Grossman, MD · Answer

There’s absolutely no better way in treating lower eyelid and cheek hallows then with the use of your own fat. With an experienced in fat grafting Plastic Surgeon, the results should be natural and permanent. With grafting you avoid the complications which are commonly and frequently seen with fillers, especially hyaluronic acid fillers. I hope this helps and good luck from New York City Plastic Surgery.

What is the best option to correct lack of volume in the lower eyelids? (photos)

Answers (7)

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