What would you recommend for hollow eyes? (photos)

Hi Jessica,If you were my patient, I would replace lost volume in your cheeks with Voluma, and then if still needed use Restylane immediately under your eye in the remaining hollows.  Make sure to choose your injecting physician most carefully as this is a very delicate and unforgiving area.  Good luck and be well.Michael Persky, MDEncino, CA

 Hollow eyes can be improved
by the use of fillers and/or Nano fat. This should
be done in the hands of a Board Certified Plastic Surgeon with expertise in Oculoplastic
surgery.

Your eyes appear to, as you have mentioned have only hollows.  Some other patients have excess orbital fat and also a hollow.  While patients often describe the hollows or dark circles as being in the eyelid, it is really more related to that upper cheek.  The reason that the hollow creates a dark circle is that the lack of volume creates a shadow.  By increasing the anterior projection of the upper cheek/lower eyelid junction, the hollow, more light is captured in the area reducing the shadow and improving the appearance.  The upper cheek/lower eyelid hollow can be corrected by either adding injectable filler, autologous fat or an implant.  The different filler options vary by country as Europe has more available filling options.  In the US the most common lower eyelid filler is hyaluronic acid.  The great aspect of this option is that it is quick, relatively painless, short recovery and very safe.  The downside is that it is temporary and will "wear off" in about 12-18 months.  While there are permanent filler options available, these carry more risk.  The second option is to use your own fat cells, referred to as autologous fat.  It is a minor surgical procedure carried out by harvesting fat cells from the patients body region, processing the fat and injecting it into the shadow.  While this procedure carries a little more recovery than a syringe based filler, it also offers the advantage of possible permanence.  The aging process will of course continue and the problem may recur, but it will be years down the road and likely not as severe.  The other drawback to autologous fat is that the amount that survives can be somewhat variable from patient to patient.  The last option is to utilize a tear-trough implant.  While this is a permanent solution, it requires surgery through the lower eyelid and carries the risks of a surgical implant including nerve injury, infection, malposition and over time (years) the implant may develop a somewhat harsh appearance which can be corrected by adding fat over the implant.  Hope this helps!