Orbital Fat Loss - What Can Be Done? I'm 49, my Eyes Look Much Older. (photo)

Looking at your photos, it seems that your upper eyelids are somewhat droopy [eyelid ptosis]. Furthermore, I think that you are subconsciously elevating your eyebrows to compensate for this.

Raising your eyelids [ptosis repair] will definitely help your upper eyelids become less hollow. But you should be aware that your subconscious drive to raise your eyelids may go away and unmask a mild droopy eyebrow.

I would recommend consultation with an Oculoplastics surgeon [or a Facial Plastic surgeon or General Plastic surgeon that has extensive experience with eyelid ptosis repair].

You can find an ASOPRS trained Oculoplastics surgeon near you. The link is provided below.

You do appear to have a deep or hollow upper eyelid sulcus. In your case, this results from drooping upper eyelids. Not extra skin, rather excess laxity in the eyelid elevating muscle. This condition is called upper eyelid ptosis and can be repaired. This should improve the appearance of your upper eyelids and should be performed before considering adding any fillers to this area. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

   I would agree there is some volume loss, but the eyelid ptosis is noticeable and should be corrected.  Kenneth Hughes, MD Los Angeles, CA

You have upper eyelid ptosis (droopy) which causes your eyebrow to be lifted in order to assist lifting the droopy upper eyelids. That causes the upper eyelid area to be stretched and unveil the hollowness that is present with aging. So, the main treatment would be upper eyelid ptosis surgery.  Filler or fat injection can be injected into the brow/upper eyelid area if necessary but that would definitely be secondary. See an oculoplastic surgeon.

I agree with trial of filler which is reversible and then if you like the effect .proceeding to fat grafting. However with micrcannulas and experience the results from fat grafting are very reliable and. Softer and more even than fillers in my hand. The key is to not over correct. Fillers or fat can always besupplemented