Very dark & hollow under eyes - anything else I can do? (Photos)

Question

I have very dark and hollow under eye. I had tear trough filler in August. Which made minimal difference. I have tried all the serums, creams and concealer. Can anyone recommend anything?

Anna Chacon, MD, FAAD · Answer

Since tear trough fillers and topical treatments have provided minimal improvement, there are a few other options you might consider:

Chemical Peels: Light chemical peels can help improve pigmentation issues under the eyes by promoting skin turnover and brightening the area.

Microneedling: This procedure can stimulate collagen production, improving skin texture and potentially reducing the appearance of hollowness and dark circles.

Laser Therapy: Treatments such as fractional laser or intense pulsed light (IPL) can help address pigmentation and improve skin tone and texture.

Platelet-Rich Plasma (PRP) Therapy: PRP involves using your own blood components to stimulate collagen production and rejuvenate the skin, which may help with both discoloration and volume loss.

Surgical Options: If non-invasive treatments are insufficient, a lower eyelid blepharoplasty may be considered to address significant hollowness and excess skin or fat.

Lifestyle Modifications: Ensuring adequate sleep, hydration, and a balanced diet can also play a role in reducing the appearance of dark circles.

Consulting with a board-certified dermatologist or oculoplastic surgeon would be beneficial to discuss these options and tailor a plan specific to your needs.

I hope you find a suitable solution soon!

Donald B. Yoo, MD, FACS · Answer

For dark and hollow under-eye concerns, there are several advanced treatments that may provide more effective results than tear trough filler alone. Based on your photos, you should consider the following options PRP (Platelet-Rich Plasma), REJURAN (Polydeoxyribonucleotide), or JUVELOOK (Poly-L-Lactic Acid). PRP is a natural treatment that boosts collagen and elastin production making it an excellent option for addressing dark circles and under-eye hollows. REJURAN helps reduce dark circles caused by sagging, improves skin elasticity, and boosts moisture retention. JUVELOOK stimulates natural collagen production for a long-lasting effect which would be an excellent choice for addressing both hollowness and fine lines under the eyes. Each of these treatments has unique benefits, and the best option for you may depend on your specific skin type and goals. It’s advisable to consult with an experienced provider who can assess your needs and recommend a personalized treatment plan.

Mustafa Aydinol, MD · Answer

You are an ideal candidate for nanofat grafting for the treatment of. hollowness and dark circles. I would also perform a mid-face lift and combine the treatment with Dermapen and other treatment options to enhance the outcome.

Keera Kang, MD · Answer

Hi Giving41646!I am sorry to hear you didn't notice much difference after your TT fillers. Since I haven't seen you in person I cannot give you the most accurate answer but through your picture, I notice some hyperpigmentation, skin losing its firmness/elasticity, and some hollowness. So I suggest you to go to a physician and get a consultation in person. I think a few sessions of laser(for hyperpigmentation) EBD (for increased skin laxity / dermal thinning) skinbooster (PN, PDRN for volume loss and wrinkles/ dermal thinning) will help address those issues. Hope this helped and good luck :)

Hilton Becker, MD · Answer

Hollowness and dark circles under the eyes can be effectively treated with micro-fat and Nanno-fat injections .Usually performed under local anesthetic.

Camille Cash, MD · Answer

A lower blepharoplasty will help rejuvenate the eyes.  Excess skin can be removed and fat grafted to the area for an improved, more youthful contour.  Visit with a board certified plastic surgeon near you for a consultation to learn more.

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