Options for Under Eye Hollows From Weight Loss?

I was diagnosed with irritable bowel syndrome and I have lost a lot of weight in my face, which creating hollows under my eyes. I have been asking around different clinics and I was presented different options. 1) Fillers (which don't last a long time) 2) Fat grafting 3) Skin tightening by laser. I was told the skin tightening lasts a very long time, but I'd like to know if any surgeons could please tell me which option would be best for longterm. Thank you!

Doctor Answers 7

No single treatment for all problems.

If by Hollowness you mean volume loss then you would be best served by replacing the volume. While fat grafting theoretically is permanent it may enlarge with weight gain in the future. Fillers like Hyaluronic acid are stable but don't last forever. I don't see the point in using laser to tighten the skin if that's not the problem.  The Hyaluronic acid fillers are certainly the most predictable and I would consider these to be the first line treatment for most patients

Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

Photos would be helpful.

Depending on your anatomy, you may benefit from one or more option you mentioned.

Fillers are the most reversible, so are the least amount of risk, so most would recommend that as your first choice.

However, in experienced hands, fat grafting may also give you a great long term result.

Lasers would be helpful if you had redundant or crepey skin.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

HA fillers - done properly, in the tear troughs, can provide 2 years of great correction

Thank you for your question.  Unfortunatley I do not have a picture and without examining your face in person it is not possible to give you a definitive answer.  Hyaloronic Acid fillers (such as Restyline Fine Lines) can give you a nice correction of the tear trough deformity.  Done properly, the effect can last up to two years and can create a dramatic improvement.  Micro fat grafting, can give longer duration of effect but has a higher complication / dissatisfaction rate then HAs if not done by an experienced surgeon.  Laser skin tightening can be combined with either of these procedure to provide smoother, less wrinkled lower lids.  Do your research and pick the surgeon that has a good reputation and who's results you have seen.  All the best. 

Scott Barr, MD
Sudbury Plastic Surgeon
4.8 out of 5 stars 39 reviews

Under eye hollows after weight loss.

Under eye hollows after weight loss can be treated several ways depending on the other problems you have. Lasers will give you skin tightening of fine lines but not do much if anything for the eye hollows. Fat grafting to the eyelids often produces bumps unless done with a blepharoplasty. I like to use Juvedem slowly and most patients need some elsewhere on the face. In skilled hands done slowly this is your best choice!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Hpllow eyes from weight loss

Thank you for the question. Every rejuvenation procedure will eventually succomb to the effect of time, gravity and body changes. The procedure that gives you longer term results would be fat grafting and laser. However, Long means months to a year. Each procedure has it drawback. fillers may last you for 6 months to a year. Fat grafting has some inherent problems such as calcification asymmetry and resorption, and sometimes nodules. Laser give you skin tightening., but not sure it will give you the volume effect that will fill the hollowing. I hope this helps.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Best options for the tear trough

It is difficult to give you precise advice without seeing photos.  In general, the two best options for hollow eyes are fat transfer and filler. Restylane is a great filler for the tear trough.  To further enhance the result, you can use Perlane or Radiesse in the cheek. Fat transfer is a more permanent option, and the fat has around a 30-50% take. Thank you, and I hope this helps answer your question.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Facial aging..

Long term improvements in facial aging are really limited to about 10 years especially in the later decades. A combination of approaches including the ones you listed is appropriate however, management of your weight loss is critically important. Stress on your body can cause loss of more than fat in your face and can accelerate facial aging.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 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.