Injectable Fillers for Hollow Upper Eyelids?

Regardless of what is injected, the upper eyelid needs to be approached with caution. The anatomy is very delicate and unforgiving, so make sure to go with someone with a lot of experience with injections in this area.
That being said, fat or Restylane can work very well, and there are pluses and minuses to each option.
Meet with an experienced surgeon in your area, or perhaps more than just one, listen to his or her thoughts, and pick the individual you feel the most comfortable with.

Upper eyelid hollowness is a dramatically underappreciated, yet incredibly important component of aging in the eyelids. With normal aging, our upper eyelid fat pads tend to retract and expose this upper lid hollowness, those with “deep set eyes“ are especially prone, and unfortunately old-school upper eyelid surgery that is overly subtractive can artificially create this hollowness early, actually looking worse than it did before surgery - the before and after photo in the link below resulted from overly subtractive upper eyelid surgery with another surgeon, and you can see the results after revolumization of the upper lids. Correcting this hollowness can happen with fat or filler injections into very specific planes of the upper eyelid, or transposing and rearranging the upper eyelid fat pads to provide fullness, as you see in this surgeon’s view video, borrowing the excess fat to move into the areas lacking fullness!
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut
#realself100 Physician

Upper eyelid filler injection is very safe, predictable, and effective, when done properly by an experienced physician. The result lasts normally 1-2 years the first time it is injected and even longer the second time. See following link/manuscript.

I often find patient in my office who are dissatisfied with the results of blepharoplasty performed elsewhere because it left them with a sunken upper eyelid appearance (upper eyelid sulcus).  In some cases, they are just not pleased with too dramatic of a difference in upper eyelid platform showing after their surgery.  Injectable fillers can be successfully used to fill these hollows, but only when done by a specialist that is keenly familiar with cosmetic eyelid surgery and has considerable experience with this procedure.  Restylane, juvederm, or belotero are all reasonable filler options, and in some cases fat grafting is also an option.  See my link below for a more detailed explanation of how hollow upper eyelids can be corrected.

Hi Sashaei,

Good question.  Yes, injectable fillers can be used to fill upper eyelid hollows.  This is an "off-label" use for fillers such as Juvederm or Restylane.  I prefer Restylane over Juvederm, mainly because Juvederm can increase in size by ~10% after the injection.  If you do a web search for "Juvederm overfill under eyes," you will find many stories of people who looked good right after the injection, but later the result is too puffy.  

 

Although hollowing of the eyelid area is not desireable, having too much puffiness or "bags" is worse than hollowing.  The goal is to fill the area until it looks smooth and flat, but not puffy.  It is important to go on the provider's website to see their before and after results, to see if the provider really has experience injecting upper eyelid fillers. 

 

I started treating upper eyelid hollowing initially with fat grafting in 2006.  I mainly performed a procedure called "Pearl Fat Grafting" of the upper eyelid hollowing, and still do.  However, for younger patients like yourself, who do not need any skin removal, I prefer to inject Restylane as an upper eyelid filler to volumize the "brow skin" or the skin between the eyebrow and the upper eyelid fold/crease.  

 

One key photo to determine if your injector is truly skilled at upper eyelid filling is the photo when the patient looks downwards.  If performed properly, it should look very smooth.  If injected in the wrong area, it can look lumpy.

 

I hope this helps to answer your question.  Good Luck!

 

Best,

Dr. Yang

 

The upper eyelid area can be corrected with fillers such as Juvederm or fat but it must be done in small increments with small needles and with precise technique.  Usually the medial portion requires more filler than the lateral or middle portion.