Hollow upper eyelid. Is there any non surgical way to minimize the look? (Photo)

Question

My upper eyelid has become very hollow making me look older than 35. Besides filler is there any non surgical way to minimise the look? Would Botox work and where would the Botox point be?

J. Smythe Rich, MD · Answer

The  consensus is weighted towards fillers delivered by catheter to the orbital rim to create or restore volume. This will camouflage the visible bone or "A" deformity. I would recommend the type filler with less water traits such as Restylane silk or Boletero. Please consult with someone with experience in this higher risk area.
Good Luck
Smythe Rich, MD
Facial Plastic Surgeon

Scott Trimas, MD · Answer

I would certainly consider fillers such as restylane or juvederm for that area. The advantage of that treatment is that if you do not like the results, it can easily be dissolved with the use of hyaluronidase. Botox will not help the hollowness and there are no great surgical options at this time.

Mehryar (Ray) Taban, MD, FACS · Answer

Yes, filler injection can be done to improve the upper eyelid hollowness you have. See following website link and corresponding gallery for multiple examples, including Asian eyelids. Also see following video.

Jason Emer, MD · Answer

A combination approach would give the most improvement. Fillers, lasers, and microneedling/PRP can improve this area. I recommend injections with cannulas to limit complications. See an expert for a formal evaluation. Best, Dr. Emer

Damon B. Chandler, MD · Answer

There is nothing simple or easy about your case. You are young and beautiful and have some challenging anatomic features. Botox has no role in correcting hollowness of the upper eyelid. Fillers are very challenging to place in that location and you need a masters hand to help -- and still i am not convinced you will be happy with fillers to the upper eyelid. You also have a prominent fold of skin/eyelid crease that needs to be discussed and it has its own unique challenges. You need an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with extensive expertise in upper eyelid surgery, eyelid hollows, and brow anatomy.  Avoid any doctor that does is not a surgeon and is not extensively trained in eyelid surgery or you may regret it.  Best of luck, as there are many excellent surgeons in Australia.
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Jessica H. Kim, MD, FAAD · Answer

I would recommend adding filler to soften and lift the eyebrow area.  This will require very superficial placement of fillers.  Be sure to see an experienced and board-certified physician.

Melvin Elson, MD · Answer

Botox cannot be used in this area as it would cause the eyelid to droop.  Fillers could be used but it is very difficult so be sure you see a dermatologist who is experienced in cosmetic work

Kambiz Golchin, MBBS, FRCS (Eng), FRCS(ORL-HNS) · Answer

Hello & thank you for your question! Botox softens the appearance of facial expression lines by temporarily reducing movement in overactive facial muscle groups.  Therefore it is not effective for treating deeper hollows/wrinkles that are present 'at rest' rather than fully raised.  
The hollowing that you are noticing would be best addressed with a HA (hyaluronic acid) filler like to help replace some of that volume.  I would recommend seeing a cosmetic surgeon to discuss your concerns and create a plan of action.  
Best Wishes,
Mr Golchin

Sean Doherty, MD, FACS · Answer

Botox works by paralyzing the underlying muscle in the treatment area so it is effective for crow's feet around the eyes, but not for "hollows" which are the result of volume loss. Putting some filler underneath your brow would help to lift your eye, giving you a more rested, rejuvenated look. Hope this helps.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  Botox is a neuromodulator - it softens the appearance of facial expression lines by temporarily reducing movement in overactive facial muscle groups.  As such it is not effective for treating deeper hollows and wrinkles that are present at rest, which are primarily caused by volume loss due to natural fat and collagen loss in the skin.  The hollowing that you are noticing would be best addressed with a hyaluronic acid filler like Volbella to help replace some of that volume.  I would recommend seeing a cosmetic dermatologist or plastic surgeon to discuss your concerns.  Best of luck!

Hollow upper eyelid. Is there any non surgical way to minimize the look? (Photo)

Answers (14)

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