Hollowness close to the eye after eyelid surgery - can it be improved with filler or fat? (photo)

Hello, and thank you for your question. While a proper evaluation of your skin is necessary, there are several treatment options to rejuvenate the eye area. Hollowing under the eye can often be addressed with tear trough fillers. By injecting small amounts of filler around the tear trough, the skin will become plump and supple, lifting the skin and smoothing out the visible groove under the eye. You may also explore lasers, Profound RF (microneedling combined with RF energy), and other procedures that help boost collagen production. These procedures are effective in refreshing the skin around the eyes. Fat grafting may also treat sunken areas beneath the eyes by adding volume to rejuvenate the face. To determine the best treatment for you, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with an extensive experience with injectables. Your surgeon can do a proper evaluation, customize the best treatment plan, and ensure the best possible outcome.

An appropriate choice of HA filler, in the hands of an experienced, board certified cosmetic dermatologist injector can work well for improving under eye hollows and tear troughs. HAs have the added advantage that, if for any reason, the filler needs to be removed, it can simply be dissolved with hyaluronidase. Fat transfer injections (an expensive two step, minimally invasive procedure requiring large bore cannulas to harvest and reinject the fat, which I gave up performing years ago) do not have this advantage. What's more, despite the promise that fat transfer results are permanent, much of the fat, once removed from its original donor blood supply, does not actually survive, and that which does retains the characteristics of the site from which it is taken (i.e. belly, thighs, hips). This means that, with aging, when belly fat, for example, develops a midriff bulge, so can the fat do so. Hope this helps in the decision making process and best of luck.