What can be done about hollowing of the extreme inner eye corners? (photo)

In our practice, we specialize in the use of micro droplet Silikon 1000, a permanent filler that may be well-suited for filling a congenital under eye groove. Hope this helps. Sincerely, Dr. Joseph

While the under-eye area is not a place for inexperienced, novice injectors accustomed to treating simple smile lines with ordinary Restylane or plain Juvederm, experienced injectors, using an appropriate, low viscosity, malleable, cohesive HA filler can effectively treat these kinds of hollows. The filler need not even be injected directly into the area of your particular concern, but can instead be molded into place to achieve the desired result. Unfortunately, as you seem already to suspect, the hard science to back up the use of expensive "bells and whistles" fraxel laser and RF devices and other treatments, such as PRP and PRF lag woefully behind the heavy marketing hype and social media buzz to promote them. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. And, ask to see his/her befores and afters prior to agreeing to proceed. Hope this helps and best of luck.

Hollowing of the extreme inner eye corners, also known as tear trough deformity, can indeed be a challenging area to treat. However, several non-surgical options exist:

1. Hyaluronic Acid (HA) Fillers: HA fillers like Restylane and Juvederm are commonly used for this issue. They provide volume to the hollow area, making it look fuller and less tired. However, there is a risk of migration or lumpiness, and the results are temporary, usually lasting 6-12 months.

2. Platelet-Rich Fibrin (PRF): PRF is a concentrate of your own cells that can stimulate collagen production and improve skin texture and tone. It's a newer treatment option and studies are still ongoing, but some patients have reported positive results. It may be less likely to cause lumpiness than HA fillers.

3. Fat Transfer: This involves taking fat from another part of your body and injecting it into the hollow area. It can provide a more permanent solution, but there's a risk of overcorrection, undercorrection, or unevenness. It's also a more invasive procedure than fillers or PRF.

4. Lasers: Laser treatments can stimulate collagen production and tighten skin, which may help with hollowing. However, they may not provide as much volume as fillers or fat transfer.

5. Topical Treatments: Prescription retinoids and over-the-counter products with ingredients like peptides and hyaluronic acid can also help improve skin texture and volume over time.

It's important to have a detailed consultation with a board-certified dermatologist or plastic surgeon to discuss these options and find the best solution for your specific needs. They can help you weigh the pros and cons of each treatment and make an informed decision.