I'm Desperate for Help Concerning Under Eye Hollows at a Young Age.

As you are young, these problems related to your eyes, such as eye bags, thin skin below eyes, and hollowing beneath eyes are not age related but rather are related to genetics and facial structure. A single solution is not the answer to your eye area problems that give you a tired appearance at a young age. Understanding that you have a limited budget, you should seek the guidance of an experienced and established specialist (as opposed to high volume medispa which sell cheap injectables)  and develop a plan which makes sense for you in the long term.

Hi Emorel.  If you are 23 years old and have profound hollows under the eyes, then you have correctly identified this as a genetic issue.  There are 2 options in our opinion, lower blepharoplasty and Restylane injections.  If finances are an issue, we would recommend the fillers.

You mentioned that you were concerned about repeating the filler injections and about mixed results.  The procedure typically lasts 9-12 months so is actually quite a good value compared to surgery.  Some filler injections are much less duration.

As for the mixed reviews, this is mostly because the technique used in this area for best results (under the muscle) is not employed by a good number of injectors who have not been properly trained.  Before and after pictures and a quick review with your injector about his/her technique should put you at ease.  Good luck.

Hollowness under the eyes is an entity that has become more and more recognized. This can give patients who suffer with it a tired, aged look. Correction of this can be done in several fashions but primarily either injectable fillers or a fat repositioning during a lower blepharoplasty are the most common treatment methods.

For patients who are young and not ready for surgery, injections are a nice way to soften the under hollows. These grooves, also called tear troughs or nasojugal grooves, can be filled with a variety of fillers including Restylane, Juvederm or Perlane. Juvederm seems to be the most forgiving in this area and has the least issues with nodularity or bruising. Of all the areas that injections are done, tear troughs are the most challenging. The skin is thinner in this area and with this any irregularities are more visible. In addition, because of the vascularity of this area, bruising is more likely. Patients considering injections around the eye area should be sure that they have a definite deformity that would benefit from improvement. With the right patients, however, injections in the tear trough can provide a rejuvenated appearance with minimal down time and at a reasonable cost. For young patients, this can be a great option.

Surgery is another option for under hollows. For patients who have prominent fat pockets with a very visible orbital rim, repositioning of the fat can allow rejuvenation of this area. Fat repositioning during blepharoplasty takes a little bit more time and skill. It involves the surgeon freeing up the redundant fatty tissue in the eye area followed by creating a pocket along the areas of hollowness. The fat is then secured in this area; there are a variety of ways to accomplish this, either being sutured to the deep periosteum or over the skin with an absorbable stitch. Whatever technique is used, repositioning of the fat addresses two issues: 1) Removal of the redundant fat; and 2) Softening of the eye hollows. For patients who have both of these problems, lower blepharoplasty with fat repositioning is a great option.

The first step to seeking help for under hollows is to consult with your facial plastic surgeon to evaluate your anatomy as well as consider possible treatment options.