I Need an Expert with Fixing a Sunken Eyed Appearance, Options? (photo)

I have always had deep set eyes, but they seem to keep getting more deep set . Most of this problem is in the area of my upper orbital rims and next to my nose. I have nice full cheeks-but unfortunately they serve to further highlight the sunken look of my eyes. I need a recommendation for an expert in the San Diego area.

Doctor Answers 5

Fat grafting for hollow eyelids

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Hollowing around the eyelids is a significant problem which a lot of people suffer from, but many never realize they have.  Fat loss from the face occurs in the face and around the eyes in an insidious manner over decades.  You wake up one day and you have hollow eyes.  I have taken care of this problem with fillers such as restylane and juvederm, as well as with fat grafting.  In your case, i would prefer fat grafting.  when using fillers, one must stay very deep, under the muscle for fear the product will be visible.  With fat, one can inject in multiple layers including more superficially to alleviate fine wrinkles.  The upper lids can be even more tricky as the skin is thinner than in the lower lid.  So, here again, I would prefer fat injections as they tend to be softer and less lumpy in the upper lids than the other injectible products. 

One thing is for sure: go to only the most experienced injectors for peri-orbital treatments.  There is a steep learning curve.  And, you don't want to be one of the first patients the injector has treated.

Having said that, periorbital fat grafting is one of the most gratifying procedures I perform here in San Diego as it restores the essence of natural youth to the eyes, without leaving them with an operated appearance.

Good luck!

Add Volume to Deep Set Eyes with Fillers

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Practicing Oculofacial Cosmetic Surgery in New York, having deep set eyes and hollowed appearance is a common reason patients ask me for help with. There are certain sunken eye treatments that are less invasive and beneficial for adding volume to the eye area. Hyaluronic acid fillers (ex: Restylane) can be injected along the rim of eye as well as under brow. Platelet Rich Plasma (PRP) and Platelet Rich Fibrin Matrix (PRFM) are also very helpful for sunken eyes, often referred to as the Vampire Facelift, which I offer in New York offices. By drawing your blood, platelets and growth factors are extracted from blood and used as injectable filler to the eye area with volume loss. The advantages of the The Vampire Facelift or PRP injections is that there is some of your body's natural collagen being generated, so when the sunken appearance becomes more pronounced, this method helps to build collagen and thicken the skin. As you age, volume of soft tissue, bone, fat starts to diminish; so if you have deep set eyes, you can naturally have a more sunken eyed appearance. There is no 100% perfect solution for deep set eyes as this is a function of your anatomy: your eyes relative to the bone have particular positions. You cant push the eyes out, however, you can enhance skin quality (with lasers or chemical peels) and add volume around the eyes (with PRP or Restylane), but it has to be done artfully by a qualified doctor able to perform these cosmetic seye treatments. I have seen many people who need my help after having kit incorrectly end up looking "lumpy" after getting injectables and creating too many irregularities.

Tear Troughs and Hollows Under the Eyes Respond Well to Treatment With Volumizing Fillers

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Tear troughs and hollows under the eyes are a common result of the loss of volume in the cheek area over time. The once robust, convex (outwardly projecting) fat pad that sits under the eyes in youth shrinks, shrivels and goes Southward and inward toward the nose as part of aging (also accentuating smile lines and marionette lines). In addition, there are also changes in the shape and amount of the bones in the cheekbones themselves.

These changes, all of which relate to volume loss and volume displacement, lead to the formation of the tear troughs and hollows and flattening of the upper inner cheek (in the region where it sweeps upward toward the inner corner of the eye). Since volume changes are the root cause of these problems, volume replacement, which can be quite easily and quickly accomplished nonsurgically with fillers, such as Juvederm UltraPlus XC, is an ideal, noninvasive solution that yields gratifying results. 

Treatment of tear troughs

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Your posted photo shows visible tear troughs. Currently the most popular way to address that is fillers (injectable, fat etc.).

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Fillers for sunken eyes.

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Fillers for sunken eyes can smooth out the sunken in appearance of the lower lids. Juvederm or Radiesse can be used depending on the thickness of the skin. It should be done to slowly build the area up without making bumps.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.