I Have Hollow Under Eyes, Are There Any Permanent Solutions? I'm 22

Question

I have attached a few pictures. I have been told that this is a tear trough deformity. Are there any permanent solutions to make this go away? I'm young so I can only imagine this will look alot worse when I am older. thank you

Michael Horn, MD · Answer

Hi. A simple solution for your hollowness under the eyes is an injection of a filler (such as hylaform). Filler can improve the area and usually lasts nine months to a year. Another way to treat the area would be with injection of fat taken from your own body. The fat may last longer. Be certain to use and experienced surgeon because treatment of this particular area can be tricky.

Eric M. Joseph, MD · Answer

I read your concerns and reviewed your photos:

	You appear to have typical lower eyelid grooves that some refer to as "tear troughs". In my practice, I prefer to use Silikon-1000, an off-label filler for permanent results to fill these grooves.

	Hope this is helpful for you.

	Dr. Joseph

A.J. Amadi, MD · Answer

Fat grafting or fat transer [different names for same procedure] would be the best long term solution with you issue. The amount of fat transfer has to be conservative and deep to minimize chance of contour irregularity.

	Temporary fillers can be helpful but will need to be repeated.

Toby Mayer, MD · Answer

You would do better to have a temporary solution like Juvederm or Radiesse placed in the hollow. Very often permanent solutions can create lumps and bumps which then become permanent require surgery to remove them.

Craig Mezrow, MS, MD, FACS · Answer

There are options for treating tear troughs or hollowing under the eyes. These include operative and nonoperative procedures. Fat grafting is option that is natural with long lasting results. A nonoperative procedure would be the use of hyaluronic acid products, such as Restylane or Juvederm.

Jeremy B. White, MD · Answer

Hi Eliza,

	 

	The tear trough deformity is usually caused by descent of cheek fat, thereby causing a hollowing below the lower eyelid in comparison to the cheek fullness.  This is something that usually gets worse as people age and becomes more noticeable if the lower eyelids begin to show signs of aging with fat herniation.  When a prominent tear trough develops at your young age, there is usually a genetic component to the occurrence as well. 

	
	It is difficult to give you a complete recommendation about permanent correction without a full face photograph and an in-person consultation. Options to rejuvenate this area in younger patients generally revolve around fillers.  Injectable fillers like Restylane and Juvederm are easily obtained by your surgeon off the shelf and they can last 6 months or more.  Fat injection into this area is a potentially permanent solution, although this requires you to get a small amount of liposuction and possibly multiple treatment sessions to get the right amount of fat to survive where needed.  Unfortunately, non of these options will stop the aging process long term.  You should seek consultation with a plastic surgeon if you would like to consider these options further.

	 

	I hope that this helps!
	
	Jeremy White, MD

I Have Hollow Under Eyes, Are There Any Permanent Solutions? I'm 22

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