Long-term treatment for under-eye hollows? (photo)

Question

I am so tired of these ugly tear-trough hollows that make me look so much older. My dermatologist recommended Restylane injections. It's cost beneficial for my doctor if I keep getting these injections, but not for me. I would rather pay a lump sum for something that will benefit me longer term. What would you recommend? I am 25 years old, and I have never had any cosmetic surgery or injections. Please see pictures, and thank you!

Stephen Weber MD, FACS · Answer

Filler is a great option for undereye hollows. I avoid permanent fillers in this area as any problems that are created with the injections are, in fact, permanent and difficult to remedy. In theory fat transfer can be used in this area and many advocate it but I've found the longevity of the fat is unpredictable and you have the risk of lumps and bumps. Dermal fillers like Restylane do need to be repeated about once each year but the results look natural and any bumps or asymmetry can be remedied either with a small amount of additional filler or treatment with Vitrase. Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Thomas Buonassisi, MD · Answer

There are many treatment options. At a young age like yourself I would avoid a surgical procedure for now. Temporary fillers would be the lowest risk procedure for you. See a surgeon who performs all types of lower eyelid surgery and fillers to get an objective assessment.

Sabrina Fabi, MD · Answer

The actual bone structure responsible for the hallows one sees, is constantly changing.  Therefore, a permanent solution is difficult.  If the hallows are in part caused by volume loss, I prefer using a hyaluronic acid filler.  If it is skin changes accounting for crepiness under the eye, I like to use a fractionated CO2 treatment. Ultimately it is a combination approach, addressing the different signs of facial aging that give a natural and enhanced result.

Eric M. Joseph, MD · Answer

Based on your photos, you may be a candidate for lower eye lid filling. Our experience is strictly with Silikon-1000, an off-label filler for permanent results. The skill of your doctor is imperative when filling your delicate under eye area.Hope this helps you.Dr. Joseph

Kenneth D. Steinsapir, MD · Answer

It would be great if the surgery was as good or better than the under eye filling with Restylane.  The reality is that when properly done ( and it does take a fussy injector) under eye Restylane filling is the best treatment we have for the under eye circles.  The treatment is far better than any surgery we have.  You look like you would do well with the a small volume of under eye filler.  In someone your age, treatment can last well over a year.

Long-term treatment for under-eye hollows? (photo)

Answers (8)