I've always had a little bit of hollows but after some cheek filler it has gotten worse. Suggestions? (photos)

Question

No injectors in Connecticut can seem to fix this! I need to do something to correct this before it gets more prominent. Please give me suggestions. I know filled is an option but my state is just soo minimal in everything injection wise.

Nelson Lee Novick, MD · Answer

It is surprising that you cannot find an experienced injector in your area. The infraorbital hollow that you circle in the photo is a rather routine problem that is treated practically every day in the practices of experienced injectors. I have, in fact, been personally treating this region with fillers for well over three decades going back to the days of the original collagen filler, Zyderm I. My last patient of the morning today was coincidenally a patient with this particular issue. If, in this case, the hollow was made more prominent by the use of a robust cheek filler, then some of that filler may first need to be dissolved in order to reestablish a more gradual transition between the upper cheek and the lower lid regions. Be sure to seek out a board certified cosmetic dermatologist or other core aesthetic physician and make sure to ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

Jason Emer, MD · Answer

plasma pen, and fillers can help under the eyes. these can be worsened when fillers are placed in the wrong angle under the eyes.

at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin 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.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. It appears your cheek filler was not placed in the best location and as a result, you are seeing the hollows and crease beneath your eye. This can be easily remedied either by adding a bit of filler to the tear trough area, or adding the filler and then using a bit of hyaluronidase to dissolve the excess filler in the cheek area. I encourage you to find a skilled, experienced injector in your area, as this is a common treatment location and most experienced injectors will know how to treat it correctly.

Anshul Gambhir, MD · Answer

Thank you for your question! If you aren't having much success with filler then you could always consider PRP injections for the under eye. This can help stimulate some collagen growth to help fill in those hollows. Otherwise filler is really the main treatment option for your concern. Hope this helps!

Robinson Facial Plastic Surgery - Alpharetta · Answer

Good morning,Thank you for your question. From your photos, particularly the second one, it appears that your filler was placed very high, and not distributed very well, which is causing the appearance of accentuated hollowing under your eyes, and the medial cheek. To soften the surrounding areas, I would place a little filler under the eyes, and toward the middle part of your cheek, so that one area blends well with the other. My recommendation is to find an injector in your area, or in a nearby state, that is knowledgeable, and skilled, in treating under the eyes. If this is not a viable option for you, I would do one, or more, of the following, depending on how much it is bothering you: 1) massage the filler, as to distribute it better. This takes a bit of pressure, and is most effective within a few weeks of being injected, 2) do nothing; allow it to metabolize it on its own, and 3) have the filler dissolved. I hope this helps and wish you the best of luck.
Ivette M. Ballara, RNRobinson Facial Plastic Surgery

Jo Herzog, MD · Answer

Usually cheek filler improves the periorbital hollows so I not sure exactly what has happened but I do think that this can be improved. I would use a soft filler right in area where these hollows are. I would not promise that they would be gone but they can certainly be softened. You should be able to find a dermatologist with a lot of experience with filers even in your tiny state.

Sonam Yadav, MBBS, MSc - Account Suspended · Answer

The swelling (possibly worsened due to incorrect placement of filler) is exaggerating the appearance of our lid cheek junction. Based on the details of your last procedure and medical status, hyaluronidase injection may be needed to dissolve the problematic product. Correct placement of filler in the tear trough and mid cheek by an experienced injector will resolve this issue.

Robert T. Buchanan, MD (retired) · Answer

Without knowing exactly what you had, it appears that whoever did your cheek filler placed the wrong filler in the wrong place.  This depression is very common and easily treated with a heavy filler right on top of the bone pushing the ligament above it upward and, thus, filling the superior space.  If this does not work completely, you may need some of the other filler removed.  I also do not know who you have seen to care for this area, but I am sure there are some good plastic surgeons who do fillers and understand the anatomy who could help.  Unfortunately, a great majority of the people that do fillers do not understand this area of what is necessary in order to treat the problem you have.  Look for someone who has been doing fillers for a long time and changes there methodology based on your knowledge and that can show you excellent results for this area.

I've always had a little bit of hollows but after some cheek filler it has gotten worse. Suggestions? (photos)

Answers (8)

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