Injectable Fillers for Hollow Upper Eyelids?

I had Blepharoplasty done 4 years ago (28 years old) but my upper eyelids are so hollow I look like I'm 45! Can juvederm be used to fill out this area?

Doctor Answers 11

Be very cautious with upper eyelid injections

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.

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Fat Grafting for Hollow Eyelids - Natural Lasting Results View Photos for Evidence of Efficacy

Many very attractive people (celebrities included) with hollow upper eyelids could look much younger and attractive with natural-looking fullness in their upper eyelids. The correction of hollow eyelids, when performed expertly by a plastic surgeon with considerable experience and expertise in structural fat grafting can provide a beautiful and natural looking result.

My approach to upper eyelid surgery is to be conservative with skin excision, and to reserve excision of fat for patients with significant fat excess. In my opinion, aggressive removal of upper eyelid skin and fat is a 'skeletonizing' procedure which risks making eyes appear more deep-set and aged, rather than younger. In fact, in many patients I perform structural fat grafting (using the patient's own fat, from the abdomen or hips) to help restore soft tissue volume around the eyes.

The next time you flip through Vogue or Allure (guys, just grab one at the checkout stand) take a close look at the eyes of the models. In most of them, women in their teens and twenties, you will see only a sliver of the upper eyelid, if it is visible at all. In many, the upper lid is completely obscured by soft tissue fullness between the brow and eyelashes, which I sometimes refer to as the 'brow roll'. Perusing the fashion magazines provides quick confirmation that the youthful upper lid is not a skeletonized upper lid.

Following fat grafting to the upper eyelids most patients report that people tell them “you look great” but they cannot detect what has changed.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Use fillers for hollow eyelids very conservatively

Yes, however it should be given very sparingly. If too much is given, one may develop excessive "puffiness". Small amounts can be given beneath the skin to increase the volume, especially in the inner aspect of the eyelid. The Juvederm is given with a very fine needle, and may require several injection sessions to achieve the desired results. The effect of the Juvederm may last up to 1 year.

Wilfred Brown, MD
New York Plastic Surgeon
4.7 out of 5 stars 13 reviews

Restylane is better for upper eyelid hollowing

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!



Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Injectable Fillers for Hollow Upper Eyelids?


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.


Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 109 reviews

Juvederm for hollow upper eyelids

This is a major problem after upper blepharoplasty. Juvederm is an excellent choice for filling in this deformity. It is best to seek a board certified plastic surgeon who is comfortable with these injections. I recommend starting with small amounts of juvederm injected over multiple sessions. Micro fat grafting is also a great choice, however, over-injection errors with fat are not so easy to reverse.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 45 reviews

Use fillers on upper eyelids carefully

Whether we use fillers or your own fat, this area is extremely sensitive to any type of augmentation. It should be done only by someone with a great deal of experience and usually with Juviderm is done with 2 or more injections, so as not to create a lump.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Filler injection for hollow upper eyelids is safe when...

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.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Upper eyelid filler to correct hollowing after blepharoplasty

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.

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 58 reviews

Fillers are excellent for filling eye area hollows

As we age, we lose volume in our face. This includes the upper eyelids, eyebrows, and orbit. Changes that make us look aged include not just skin drooping, but loss of volume in these areas, and hollowness around the eyes.

Blepharoplasty surgery is designed to reduce fat in the orbit and tighten the skin of the eyelids. If you had a blepharoplasty that removed a lot of orbital fat, then it may make you appear very hollow. This may make you look a lot older than you really are.

You are right to ask about volume enhancement with Juvederm to reverse some of these changes. Juvederm is an excellent choice for your problem. The filler can be used to add volume to your orbit, eyelids, and brow to produce aesthetically pleasing contours. Another option (perhaps more permanent) would be fat transfer to your brow and orbit areas.

Good luck!

Tanuj Nakra, MD, FACS
Austin Oculoplastic Surgeon
5.0 out of 5 stars 23 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.