What Are Some of my Options (Cosmetic Procedures) to Get Rid of my Under-eye Wrinkles and Hollowness? (photo)

I'm in my early 20s but I've had under-eye wrinkles, hollowness, and darkness since I was a teenager. I believe the under-eye wrinkles and hollowness are due to the excess in under-eye skin and my high nose bridge bone (bump on the nose). The bone seems to cause a "pull" on the skin causing the hollowness effect. As my nose started to grow, I found that the hollowness became more prominent especially in photographs where a "flash" is involved or "wrong" lighting for the face. Please see photo.

Doctor Answers 12

Under eye troughs and dark circles.

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I agree with all the other responses regarding the tear trough filler or fat grafts. 


I would also add that there is a skin care product to help assist with the dark circles. I have found that SkinMedica TNS Illuminating Eye Cream helps to reduce the appearance of the dark pigmentation in this area.


Congenital Under Eye Hollowness

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What you have is a prominence of the levator labii superioris, one of the facial muscles that originates on the edge of the orbital rim. The only way to improve this is to fill the depression with either fat or a manufactured filler like Juvéderm or Radiesse. Although the fat may take two injections to get the result you want, it should be relatively permanent.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

Dermal fillers are a good options

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Given your age, a dermal filler, such as Restylane is a good option. This can be placed in the tear trough area to make your eyes appear less hollow. This should also help the "wrinkles" under your eyes. It will not likely help, though, with the discoloration. 

Sandy Sule, MD
Dallas Facial Plastic Surgeon

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A Filler Would Work Well for Your Hollow Under-Eye Area

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A hyaluronic acid filler (Restylane or Juviderm) would be a great option for your under eye area. It would lift the tissue upwards to smooth the junction between the top of the cheek and the lower eyelid. While it would likely not change the color of the skin, it would make a big difference with the hollowness that you don't like.While the size of the nose does not actually pull the skin, it does change the way light and shadow hits the area, and because how we see things is related to perspective, the taller the nose, the more hollow the eyes will look. Given this, filling the hollows will not only make the lower lids look better, but will also likely make your nose look a little smaller. Because the eyelid skin is so thin, a topical anesthetic cream usually is all that is needed to make the injections comfortable.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 27 reviews

Fillers for Under-Eye Hollowness

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A dermal filler injection, like Restylane, injected into the tear trough (the area below the eyes) can help fill the "hollowness" you are referring to and lift the tissue under the eye for a more youthful and less "baggy" appearance.  However, please keep in mind that a filler injection may not address the dark color of the area.  Additional skin care treatments may be able to help with the discoloration.

Mid and Lateral Cheek Augmentation Works Well For Rejuvenation Hollows and Bags Under Eyes

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Just as there has been a trend away from treating wrinkles by simply injecting right into them, there has been a trend away toward simply filling tear troughs and hollows. We now know that rejuvenatiing the facial and eye units requires an artist's eye towards recontouring and revolumizing the surrounding areas so that the various units and areas of the face blend and merge seamlessly as they did in youth.

In the case of tear troughs, hollows, elongated lower lids, and bags under the eyes, whether from age or genetics (or both), we often find that an artful treatment of the mid and lateral cheek areas directly beneath the elongated lid to cheek margins with a volumizing agent, such as Radiesse in the U.S. (or elsewhere in the world Voluma) provides sufficient buttressing and support to reduce the need for treatment (or the amount used if treatment is still deemed appropriate) directly into the tear trough area themselves (which may sometimes lead to persistent, unsightly swelling). 

Only a very experienced injector should attempt such treatment, but in well-trained hands, the results can be extremely gratifying. The additional good news is that many in the field believe that if such treatments are initiated early enough in life, the aging process can be slowed up dramatically and the need for ever having aggressive, invasive surgery reduced substantially.

Restylane is a great first line option

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Your hollowness is due to your bony and soft tissue anatomy. The soft tissue can be augmented with deep placement of fillers on the eye socket bony structure.

The darkness of the eyelids is related to your skin tone, and although the shadowing will be improved with the fillers, some residual darkness will still be present.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Your Eyelid Bags Can Be Treated With An Injectable Filler

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When I look at your picture, you have a defiency of volume underneath your eyes and in your cheek area.  When you dont have enough volume, you can develop ""bags" underneath your eyes.  The bags are where the skin is just above the bone and the line forms where there is much more tissue between the skin and bone at the cheek.  Placing filler to fill the bag will considerably improve the appearance of the area.  In my hands, I prefer to use Restylane with a blunt cannula to fill in the area.


I hope this helps

Tear trough depressions

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The tear trough depression can be softened with filler materials. If it is more pigmentation issues, than the fillers may  not help.  An exam in person is a good idea.

Tear troughs or lower eyelid hollows

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You have obvious "tear troughs" depression (hollwness) under your eyes, which is genetic in your case.  The best and safest treatment option for you is injectable fillers (Restylane), which can last a long time.  See an oculoplastic specialist.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.