What Type of Facelift Will Correct Under Eye Hollowness?

   A physical exam would be imperative to sort your specific problems, but a combination of fat grafting and/or cheek resuspension may be in order if you have hollowness at the lid cheek junction.  Sometimes a lift is not necessary.  You may need filler or fat grafting.

The key is to blend the eyelid/cheek junction and this is done with a 5 Step Blepharoplasty for lower eyelids where you reshape and camouflage the eyelid/cheek junction with or without removing eyelid fat and then restoring deep malar fat to provide for shaping of the eyelid/cheek junction.

Dear BrookeCO,


The combination of a facelift and fat grafting gives really nice results to solve 2 different problems

They complement each other in the treatment of the aging face

If your neck and jawline are fine, then just stick to lower eyelid treatment


Best regards,

Nima Shemirani

An endoscopic midface lift will elevate the soft tissues in your cheek and restore some of the volume under your eyes.  A certain degree of improvement may also be noticed after a deep plane facelift if your surgeon takes the dissection medially enough.  Depending on the cause of your under eye hollowness, lower blepharoplasty with fat repositioning and fat grafting may be the most appropriate treatment to correct it.  

Hi BrookeinCO,

Treatment of under eye hollowness depends on the condition creating the appearance of hollowness. Fillers are used to treat areas of volume loss. Surgery is performed to remove or reposition fatty herniations that can give the appearance of lower eyelid hollowness. Often, both treatments are recommended. Diagnosis by a facial surgeon is necessary to determine which treatment(s) is best for you.

Best of luck,

Dr. Tom Kaniff

A face lift will not correct under eye hollowness. As we age, our faces lose collagen and fat resulting in midface (cheek) volume loss. Typically the best treatment for volume loss is dermal filler such as restalyne or Juvederm. Transferring fat to this area is a great solution as well.

Unfortunately a facelift will not correct this type of problem.  A facelift focuses on the lower part of the face, jaw line, and neck.  The procedure that is beneficial to the lower eyelids is lower blepharoplasty with fat transfer.  The fat is usually harvested from the outer thigh, processed, and  injected into the hollows around the eye.  This procedure combined with a lower blepharoplasty greatly improves the appearance of the lower eyelid area.  Both procedures are easy to go through and give a great result with minimal down time. There are other options such as Juvederm or Sculptra that can fill the hollows, but they do not work as well as fat.  Consult with your board certified facial plastic surgeon to discuss the best options for you. 

 

 

 

 

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What you described may best be treated with fat grafting or fat transposition during a blepharoplasty.  Facelift is unlikely to correct what you have described.

Dr. ES

Facelift is unlikely to correct under eye hollowness.  Lower blepharoplasty and/or filler or fat injections are more likely candidates.  See an oculoplastic surgeon.

Some physicians perform a high SMAS facelift.  This is fundamentally different from the SMAS facelift, deep plane, composure, etc. that we all learned in our residency training.  However the skin should not be pulled in a purely upward direction without altering the hairline and direction of pull of the face.

 

The high SMAS facelift lifts the SMAS to well above the zygoma, into the area beside the eye.  Therefore it is possible to lift the outer portion of the cheek with the facelift procedure.

 

Still, for lower eyelid hollowness to be corrected, it is often helpful to lift the central cheek as well, and this can be performed through the outer lower eyelid.

 

Occasionally, grafting below the eye is useful.  I say occasionally because this area is very risky for lumps or irregularities forming.  Therefore in my opinion lower eyelid grafting should be very, very carefully performed.  I have seen many, many cases of irregularities from fat injection, grafts (including a few of my own!).  I have noticed that among doctors who successfully specialize in the midface, there is an attitude of conservatism.

 

It is often best to simply use Restylane for under eye hollows that are still present after the above procedure.  In the event there is dissatisfaction with the injections, the hyaluronic acid eventually goes away.  This is not the case for semipermanent fillers such as ArteFill, Sculptra, silicone, PMMA, etc, all of which can produce disasters.