what is best/natural and most long lasting procedure recommended for the hollow look under my eyes? (Photo)

I am 30 years old and am experiencing a tired look under my eyes. The picture makes it look worse in that specific lighting ( which is ok). the hollow area as below my eyes and above my cheek, more one side than the other. Please include recovery time and level of pain. Thank you

Doctor Answers 14

Hollows under eyes - View nmany photos before selecting a surgeon

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Hollows under eyes, or in eyelids, cheeks, or anywhere on the face can be treated with fat grafting. When administered appropriately, fat grafting looks soft and natural. and provides a beautiful, natural, healthy youthful look. A great deal of patience, expertise and experience is required on the part of a plastic surgeon to provide consistently excellent outcomes. Start by looking at before and after photos. An experienced plastic surgeon should have many, many images to share with you. The be sure to check the training of your surgeon. Check credentials of the hospital or surgical setting the procedure will be taking place. Check that the surgical team is top notch. You can do all this homework before your initial consultation. Then it is important to find a surgeon who truly understands your goals.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Treatment for under eye hollows

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Dear rmoham,

  • For a result that will last 1-2 years, Restylane under the eyes can help, there is minimal discomfort with mild swelling afterwards.  Final result takes about 2 weeks
  • For a more permanent result fat grafting (done by an experienced surgeon) will last 5-10 years (it will age naturally).  The downtime is about 2 weeks of bruising and swelling, but there are ways around it.  It does not hurt post-operatively

Best regards,
Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Filler for lower lid hollowness

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In general, options for lower eyelid hollowness/puffiness include surgery (lower blepharoplasty), filler injection, or fat injection. In your case, where the problem is mainly hollowness (not puffiness), is combination of fat and filler (or just filler) injection.

Fat Grafting with PRP is the most natural and long lasting filler

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I would recommend Gat Grafting with PRP to provide you with a very natural and long lasting results.


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Although the pictures are of poor quality, I would suggest starting with the most conservative option at your age, which would be a hyaluronic acid filler. If you like the result, fat grafting can be something to consider in the future. Grafting is a more involved procedure, and generally when undergoing fat grafting because of the effort involved we will consider more comprehensive volume enhancement to best utilize all the material that we have collected.

Arthur N. Falk, MD
Albany Facial Plastic Surgeon

The most longest lasting treatment for hollowing under eyes is fat transfer.

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Judging from your photo and your age, you are are a good candidate for a hyaluronic filler such as Juvederm, Restylane or Belotero.  However, the longest lasting treatment and most natural would be fat transfer. I have done several fat transfers to this area, and my patients love the results! It is a fairly simply and risk-free surgery when done by an experienced surgeon.

Hallow Look Under My Eyes

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The asymmetrical cheeks with a hallow appearance under your eyes can be corrected using several techniques but the most natural and longest lasting results can be achieved using implants. Post-operative pain is minimal and easily controlled. Recovery will take about one week after the surgical procedure.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

What is best/natural and most long lasting procedure recommended for the hollow look under my eyes? ABSOLUTELY FAT TRANSFER

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Autologous Fat Transfer (AFG) is absolutely the most natural, long lasting and cosmetically the best way to treat hollowness beneath the eyes, in my thirty years of using all of the available fillers.  Stanford Medical Alumni Paper asked its various departments within the School of Medicine asked to identify the greatest advance of the decade from 2000 to  2009.  For the Plastic Surgery it was realizing that facial rejuvenation was not about pulling the skin tight, but replacing lost facial volume.
There are only two permanent fillers for facial use.  One is Artifill and its spin offs which have polymethalmethacrylate beads mixed in with bovine collagen, and the other is AFG.  Artifil and the artificial permanent fillers should not be used around the eyes and are not approved for use by the FDA for this area.  That leaves AFG.
It is important to understand that in the process of transferring the fat, we loose up to 50% of the fat that is transplanted.  Knowing this, we usually transfer more to try to take into account this phenomenon.  However the other thing that need to know, is we can only about double the thickness of the area we are treating.  The lower eyelid hollow isn't very thick, but we can put fat deeply beneath in a series of fat pads that are on top of the bone of the eye socket.  In my hands, even with post hyperbaric oxygen therapy to assist the survival of fat, we have to treat this area several times, but the lasting results can be worth trouble with less expense than temporary fillers.
Dr. Seare


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First, I would recommend a consultation with one of the core surgical specialties that offers both surgery and volume restoration/enhancement. Room lighting and flash photography can make a difference in how the "circles" appear. By your age and photo (that provides limited information) I would speculate that Restylane might be a good choice, but you need to be seen to determine what, if anything, is needed.

Phillip Langsdon, MD
Germantown Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Restylane for Hollow Under Eyes

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Hello.  Because of your age and the fact that your skin is still very good, we would not likely recommend surgery.  The issue with the area under your eyes is a genetic one - the shape of the face - and this issue is easily addressed with dermal fillers.  
We prefer Restylane under the eyes.  The product works very well in this area and lasts 6-12 months.  

To see examples of similar cases, click on the link below.

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.