Under eye filler dissolved, eyes look so hollow and tired - what can I do to treat this? (Photo)

Hi there,
I can understand how upsetting this feels — it’s very common to be alarmed by the sudden change in appearance after dissolving under-eye filler. What you’re experiencing is not uncommon and often temporary. When hyaluronidase (the enzyme used to dissolve filler) is injected, it not only breaks down the filler but can also affect your body’s own natural hyaluronic acid in the treated area. This can cause temporary hollowing, dryness, and a sunken or tired look, especially within the first few days.

Here’s what’s likely happening and what you can do:

Swelling and dehydration: The enzyme can draw out moisture and leave the tissue looking flatter for a short while. This typically improves within 1–2 weeks as your skin rehydrates and natural hyaluronic acid levels recover.

Pre-existing volume loss: Sometimes, filler was masking natural hollowness or volume loss under the eyes, which becomes noticeable once it’s gone.

Healing period: Give your skin some time to settle. The area will usually start to look better as the tissue restores its natural hydration balance.

To help the process:

Use a gentle, hydrating eye cream or serum with hyaluronic acid or peptides.

Avoid retinol or strong exfoliants around the area for at least a week.

Keep well hydrated and avoid excessive salt or alcohol intake, which can worsen puffiness or dryness.

Once fully healed (usually in 2–4 weeks), if the hollowing persists, refilling the area cautiously with a conservative amount of filler or considering biostimulatory treatments (like Sculptra or PRF) can help restore balance naturally.

The good news is this hollow look is often reversible, and the area can be improved once the tissues fully recover.

I would fill cheek area before trying to fill area under eyes. The skin will drape differently and you might see a great improvement overall without need to go near eyes. Remember that those with more experience with this should be able to approach this in a better way and do a good job.

It is not that uncommon for people to have a multitude of issues from the fillers which have been injected into the lower eyelid area. My number one advice to you is do NOT rush with anything. You appear to still have filler or considerable swelling in the area of treatment. I personally stopped using hyaluronic acid fillers in the lower eyelid area back in 1996 for the exact same reasons and have seen hundreds of patients with similar problems to yours since that time. I prefer to dissolve hyaluronic acid filler in two and sometimes as many as three sessions with small amounts of Hyaluronidase. This way one avoids dissolving healthy tissue. I repeat the sessions every 2 to 3 weeks. I then allow for the area to get rid of all the swelling which may take as long as 2 to 3 weeks and use fat grafting to fill in the hollow. Using fat grafting, one can re-create any volume and shape that the patient desires. When properly done, the results of fat grafting should be extremely natural and practically permanent. I hope this helps and good luck from Leonard Grossman MD, Plastic & Reconstructive Surgeon.