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.
How Can I Improve Upper Eyelid Hollowness? (photo)
Doctor Answers 8
Upper eyelid hollowness.
Conservative fat grafting to the upper eyelids
Upper eyelid hollowness
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.
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Upper lid hollows
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.
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.
Filling hollow of upper eyelids
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.
Fat transfer vs. filler vs. PRP for eyelid hollowness
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