What is the best treatment to reduce the appearance of deep tear troughs/hollow under eyes? (photos)

I am a 21 year old female and I have had dark circles and deep tear troughs/hollow under eyes since I was a young child. As far as dark circles go, I can conceal them pretty well with makeup, however, the hollows don't go away so I always have a sunken eye that created a tired look. I know it is probably genetic and I have tried pretty much everything except for injections and surgery so that is what I'm looking into now. Am I a good candidate? See attached pictures.

Doctor Answers 6

Tear trough or lower eyelid hollow treatment options.

Thank you for supplying your photos and I am sorry that you
have this problem, but it is easily treated.
Filler is unquestionably the best option. The question is what one? The hyaluronic acids are okay for this area
but they have to be placed quite deep to avoid the problem of a blue hue or
Tyndall effect. In addition these
fillers do not last and you will have to keep coming back for more.

I prefer the long term filler Artefill since this filler
will last a lot longer (at least 5 year and probably longer). Artefill has an excellent safety profile and
helps you build tissue to help with any dark skin which is usually just thin
skin that shows the blood vessels underneath.
It cannot be felt and if applied with a cannula, it can literally be
"airbrushed into position to give a perfect result.

I hope that helps.

Best regards.


Kirkland Plastic Surgeon
4.9 out of 5 stars 58 reviews

What is the best treatment to reduce the appearance of deep tear troughs/hollow under eyes?

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, long lasting micro-fat grafts, and blepharoplasties. There is no one best procedure. Each has benefits and drawbacks and depends on desired outcome and individual anatomy. A hyaluronic acid filler like Restylane is a reasonable initial treatment to diminish the hollow appearance, but generally does not eliminate the discoloration .


Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Tear troughs

You have a deep tear trough and some early prolapsed orbital fat.  This creates a shadow over the trough so it looks pretty dark.  Some filler in this area should help quite a bit.  Restylane and belotero are the two best choices for this area.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Hollow eyes

from what I see in the photos I believe fillers would be the best option. You will likely still need concealer for the discoloration but the shape or hollow will be improved.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Tear Trough

Fillers in my mind represent the only solution to your concern.  I agree with my colleague that both Belotero and Restylane work well in this area.  Most important both can be removed by an injection of another medication called Vitrase if you are not happy with the result.  Of course this is very rare.  As a word of caution bruising can easily occur and last up to a couple of weeks,  so make sure you do not have any occasions where a little bruising might be awkward

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.8 out of 5 stars 14 reviews

Undereye Fillers

You might be a good candidate for hyaluronic acid filler under your eyes to add volume and reduce the "hollow" look.  Some good fillers for this area are Belotero and Restylane.  Be sure to find a plastic surgeon who is experienced in injecting fillers in this area.

Scott Greenberg, MD
Orlando Plastic Surgeon
3.5 out of 5 stars 14 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.