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

Hollowing under your eyes at your age is not attributed to aging but rather
to genetics. This relative hollowing particularly in some distinct areas such
as in the tear trough and the eyelid to cheek junction is referred to as the V-deformity.
This is at the junction where the bone of the eye socket meets the cheek. As a
cosmetic oculofacial plastic surgeon, I deal with this issue a lot and we
always want to have procedures which are predictable, consistent and allow for
quick recovery.



Hollowing essentially means volume loss. We will restore this area with
some kind of volume. In our practice, we restore volume with a hyaluronic acid
filler such as Restylane. However, in contrast to the nasolabial folds where
the skin is thicker, the eyelid skin is very thin. It is a challenge to place
Restylane because it might produce lumps and irregularities. You should choose
someone who has a lot of experience in this area. In addition, when you start
doing some filler, there is some maintenance involved. Some people need to come
every 3 months, every 6 months or even every year. There is a lot of
variability in every individual in the way they metabolize hyaluronic acid.



Hollowing involves shadows and darkness in the under eye area and even
fine lines and wrinkles. In our practice, we found a very synergistic benefit
with a material called platelet-rich plasma (PRP) combined with hyaluronic
acid. Platelet-rich plasma is derived from your own blood. We do a typical
blood draw like in a doctor’s office or lab and it is put in a tube and spun.
Through this, we are concentrating the growth factors that are responsible for
wound healing. This combination results in volume and skin quality improvement.
There is some type of benefit in the combination of PRP and hyaluronic acid as
opposed to each one being used individually. We follow our patients very
closely so that we can make sure that there are no irregularities. And if there
is a needed enhancement or touchups, we can do that as well to make sure that
the contour is just as desired and looks natural.



I suggest that you look for physicians or cosmetic surgeons who work at
this area a lot. I advise that you don’t always follow the hype of the toys or
the materials. Sometimes doctors promote little instruments like blunt cannulas
and things like that. I don’t mean to put those down, but really it’s more
about technique than is about a particular instrument. It’s about the hands of
the surgeon that make the difference and how it’s applied. It’s very meticulous
and sensitive area so it has to be done with great care and artistry. Meet with
doctors and find someone you are comfortable with and give it a try. What’s
really nice about this option is that hyaluronic acid can be dissolved, so if
you don’t like it, you can use hyaluronidase to get rid of it. I hope that was
helpful, I wish you the best of luck, and thank you for your question.



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 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.