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!

 I would recommend fillers in the  periocular area. To start with I would use Restylane in a tear trough region. Other areas of enhancement can be discussed in the choice of filler would be based on the patient's expectations.

There
are many ways to treat dark circles under the eyes. It is important to
note however, that the majority of times the cause for this is genetic
and due to the blood vessels below. It is important to see a cosmetic
dermatologist who is well trained in skin care, lasers, and fillers, as
the majority of cases require a combination of treatments to give you
the best results. All my patients are on topical lightening creams and
sun protection as well as antioxidants to improve the skin texture and
tone. Many get peels or lasers to help tighten, improve the complexion
and decrease wrinkling. Fillers can replace lost volume and cover up
the vessels below to make the discoloration less noticeable. Laser
genesis, sublative radiofrequency, and nonablative clear and brilliant
lasers are procedures my patients love for this condition. You best
next step is to find someone reputable and experienced for a formal in
person evaluation for facial rejuvenation. Best, Dr. Emer.

The under eye area is actually a very fussy area.  Radiesse should not be used to fill this area.  The reason is that if there are any lumps or bumps, they cannot easily be adjusted.  I do not think that Juvederm or Belotero are right for this area either.  These so-called smooth fillers do not hold were placed and tend to drift into the top of the cheek.The only product for this area in my opinion is Restylane.  It holds where it is placed.  It has to be sculpted into place.  It tends to persist well over a year.  The key is finding a very experiences injector who can accomplish the service you need.

Dark circles, hollows and tear troughs are fairly common problems even in persons in their twenties. About three decades ago, all we had to treat the under eye area nonsurgically was injectable collagen and this was primarily used to fill the tear troughs. Nowadays, we are very fortunate to be able to treat not only tear troughs, but hollows, dark circles and even sacs under the eyes with far more sophisticated materials. Although a number of fillers have been used for this purpose, including Juvederm and Restylane, I prefer the use of  Belotero Balance combined with Radiesse (in my Upper East Side Manhattan office) and Teosyal Redensity II and Radiesse (in my Israel satellite facility, where a far greater number of regulatory agency fillers and volumizers are available). Belotero and Teosyal Redensity II have little tendency of engendering the unwanted, bluish Tyndall Effect that may occur when a filler is injected superficially within the delicate tissues under the eyes. Microdroplets of Radiesse, a whitish colored material, when added to the treatment can help to lighten the darkness. A word of caution: treating the infraorbital area is not for novice injectors. You would do well to seek consultation and treatment by a board certified core aesthetic physician with extensive experience and expertise in treating this very important cosmetic region.

The dark circles in your case are caused hollow under eyes. They can be improved by filler injection in the hollow areas. Best to see an oculoplastic specialist.

Jessica - from your photos, it appears that filler to your tear trough would be the best option for you.  Remember that this is temporary, so you can always try it and see if you like it.  A consultation in the office is necessary to evaluate all of your concerns and to figure out which treatment is ideal for you.  Best of luck!

Thank you for your question. I would recommend fillers under your eyes and maybe even some Voluma in your cheeks. You should consult with an experienced injector in your area. Good luck.