How Can I Improve Upper Eyelid Hollowness? (photo)

Hello, what is potential of improving this area? I don´t have a normal amount of fat here (whole my life). I was thinking about fillers (Rest., Juve.) to reduce the lack of fat in this area but I´ve red too many sad stories and saw many unpleasant results (and complications) to do such a thing so close to my eyes. Would be structural microfat grafting better option (but what about Fat necrosis? Or somehow tighten sunken skin close to upper eyelids using Aptos or other technique? Thnaks a lot.

Doctor Answers 8

Upper eyelid hollowness.

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Leave you lids alone--they look normal and do not need anything. You can always find a surgeon to tell you what you want to hear!

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Conservative fat grafting to the upper eyelids

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You are the kind of patient who would benefit only from a very, very conservative fat grafting to the inner upper eyelid. By searching the fat grafting before and after section on Realself, and on the websites of plastic surgeon with expertise in fat grafting, you can take a look at many patients who have had very minor fat added that has resulted in a more youthful and vibrant appearance.  Be certain you do not find a surgeon who believes in overfilling the eyes, or any area of the face with fat. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Upper eyelid hollowness

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Eyelids are delicate structures with the thinnest skin in the body.  In order to avoid problems (lumps, etc), it is best to use absorbable fillers that are also reversible. The best is Restylane. I have a written an article on this topic, which you can find on my website.  Consult an oculoplastic surgeon to determine if you are a good candidate for it.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Upper lid hollows

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Although filler might be an option, if carefully injected in small increments, my gut reaction is to point out that everyone's facial architecture is different and not to encourage you to rush to get those upper eyelid hollows treated.  I also note that you ahve some early aging in the glabellar area and low brows.  One possibility is to see a plastic surgeon in consultation to determine whether the problem is, in fact, brows that might warrant elevation at some point in the future which have created the impression of upper eyelid hollows or to consider botox to the glabellar area for brow elevation.  This can't be assessed just by a photograph and may be a reasonable query to pose to a plastic surgeon. 

You may consider consulting an oculoplastic surgeon to see if you're a candidate for ptosis repair.

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I read your concerns and reviewed your photos:

You could have the hollow you're pointing to filled, but I'm not sure this would make you look better or make you happy. That hollow area is a typical location of the upper eyelid medial fat-pad, and adding volume to this area may not look attractive.

You can see this hollow because your upper eyelids hang a bit low (ptosis), with your left eyelid hanging lower than your right. If you're concerned about the appearance of your eyelids, consult a reputable, certified oculoplastic surgeon to see what might be best for you.

I hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Filling hollow of upper eyelids

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I've filled this area with Juvederm and Restylane in the past, and Dr. Val Lambros published a paper about it some time ago.  Obviously, the operator is an important part of your outcome.  You need somebody skilled, and the injections should be done very slowly and incrementally.  You look in the mirror after each small aliquot is placed to see the result as it develops, and let the operator know if you want more, and where.


Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Fat transfer vs. filler vs. PRP for eyelid hollowness

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Hello, Daniel

You've got 3 to 4 options with some pros and cons:

1.  Filler (Restylane or Juvederm):  PROS; safe, affordable ($550), if you don't like it you can melt these "HA" fillers with an enzyme.  It's great way to see how you would look with more permanent solutions.  Should last about 9 to 12 months.  CONS;  temporary, potential bruising, need to have it injected by a facial plastic or oculoplastic surgeon.

2.  Fat transfer:  PROS; safe, quick, affordable ($1000+), if fat takes well could last up to 7 years.  CONS; could be uneven, needs to placed by experience facial plastic or eyelid surgeon (special training/experience), potential bruising

3.  PRP (platelet rich plasma from your own blood):  PROS; easy, safe, affordable ($800+), subtle, no risk of reaction since it's your own blood.  CONS; longevity uncertain (3+ years), potential bruising

4.  Surgical placement of tissue (fascia from behind ear):  PROS; permanent, costs about $2,000, reliable.  CONS:  small chance it's uneven, small surgical incison (but hidden in eyelid crease), needs special training/experience from a facial plastic or oculoplastic surgeon

Hope that helps,

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Rejuvenating Eyelids - Periorbital Volume

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Deficient periorbital volume due to aging or secondary to surgery can be restored with either hyaluronic acids (Restylane, Juvederm) or fat grafting.  

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon

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.