Treatment for Naso Labial Folds and Sunken Eyes?

I'm 33. The area around my eye orbit is begining to sink in a little. It's not as smooth as it was years back. What is the best solution that won't put a dent in my wallet? I tried botox and it made my problem worse around the eyes. Is that possible?

Doctor Answers 12

Restylane for under-eye hollows

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I would recommend Restylane to treat the "tear troughs" or under-eye hollows. Filling this area can reduce the tired, bags-under-the-eyes look by yielding a smooth transition between the lower eyelid and cheek. One syringe is usually more than enough to correct both sides. The skin under the eye is quite thin and therefore this injection area should only be performed by experienced practitioners. One of the advantages of Restylane is its ability to be quickly and easily dissolved if there is a lump or area of irregularity. For the nasolabial folds, any number of fillers including Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus, Radiesse and Sculptra can be used. 


Dr. Mehta

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Treatment for Nasolabial folds and sunken eyes

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The best treatment for a younger person who has a little depression in these areas is Restylane or Boletero.  These fillers are easy to fill these delicate areas, especially if the areas are not too deep.  Boletero is especially nice under the eyes because you do not run the risk of the Tyndall effect from the hyaluronic acid.  Find an experienced board certified dermatologist for these injections.  Botox for depression would, in fact, make it worse.  I am sorry that you had that experience.  Please let me know what happens!

Treat hollows under the eyes and smile lines

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Hyaluronic acid fillers is a great option to treat both of these areas--the smile lines (naso-labial folds) and the hollows under the eyes (tear troughs). Perlane or Restylane can be used, depending upon how deep the smile lines are. Juvederm is an alternative. I would recommend finding someone experienced--it is worth the extra cost, if any! One typically gets 6 months improvement, but results vary.

Radiesse may be an alternative, but only in extremely experienced hands.

Botox, Dysport, and Xeomin are not treatments for these areas.

Robert S. Bader, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Nasolabial Folds and Sunken Eyes-HA Fillers Restylane Only By An Expert

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Filler and fat injections are standard treatments for the Nasal Labial Folds and work very well.

Sunken Eyes, Hollow Eyes and Dark Circles under the Eyes are significant problems that require an expert. My bias is to treat Sunken Eyes with an open Fat Grafting approach. Some experts use fillers or fat injection with good results. However you need to find an expert Plastic Surgeon who is experienced with this technique and can show you excellent results from their own patients. Only HA-Hyaluronic Acid-Restylane filler should be used around the eyes and only in very small amounts-1cc or less.

Improperly injected fillers around the eyes can cause serious problems so find an expert if you are considering this approach.

A simple and more effective approach is an HA tissue filler, such as Restylane or JUVEDERM

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Yes, it is possible that BOTOX may make a sunken appearance under the eyes more obvious. This can easily be avoided by changing the BOTOX treatment technique, to avoid treatment of the lowest crows feet and the area under the eyes.

A simple and more effective approach to treating both of these areas would be to use a tissue filler, such as Restylane or JUVEDERM.  These hyaluronic acid (HA) fillers last anywhere from 8-14 months and provide a very natural improvement in both the nasolabial fold and lower eyelid areas, particularly if the problem is only just beginning. 

A more definitive approach in the lower eyelids would be to move or reposition the fat in the lower eyelids surgically for a longer lasting improvement in the sunken, tired look under the eyes.


Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Fillers for sunken eyes and nasolabial folds

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Always difficult to say without seeing someone but a filler like Restylane can do wonders for sunken eyes and dark circles.  I wouldn't give up on Botox around the can be great for the fine lines and crows feet...It may not have been done exactly how it needed to be for optimal results.  Hyaluronic acid fillers or Radiesse can be used for the nasolabial folds and/or the upper cheeks to give you a little lift and diminish the appearance of your folds.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Fillers for Sunken Eyes and Nasolabial folds

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Cosmetically sensitive areas such as the tear trough and nasolabial folds will lose volume over time and may appear sunken and darker, accentuated by shadow effects from certain lighting condition. The key is to replenish volume with fillers to minimize valleys and optimal illusion created by the shadow effects. Hyaluronic acid fillers such as Juvederm or Restylane would be the best option for tear trough areas as these are reversible with hyaluronidase in case you come across any nodularity. For nasolabial folds, you have good options of hyaluronic acid fillers or Radiesse.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

Treatment for Naso Labial Folds and Sunken Eyes?

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It sounds like you need a filler like Restylane to solve your problem.  This will increase your orbital volume which will rejuvenate your periorbital area.  Botox paralyzes muscles and might help for wrinkles, but it will not replace volume.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Periorbital Revitalizer

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Juvederm or restylane, two hyaluronic acid based dermal fillers, are the anchors to a periorbital revitalization treatment.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Restylane for Sunken Eyes

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Hi Glow,

It sounds like Restylane or Juvederm and not Botox would be the right choice for the issues you are trying to address. We commonly use Restylane for sunken eyes and for the nasolabial folds. As far as the pricing goes, Restylane for the under eye area is usually priced between $450 and $750 in Los Angeles. The nasolabial lines depend on how many syringes are used, but a 1 cc syringe averages about $550 in our area and patients require between 1-3 depending on age and correction required.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

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.