What will correct my under eye hollowness? (Photo)

Question

I’m 42 years old and I have severe hollows under my eyes. I’ve read about fillers and fat transfers but a lot of people have had bad reaction to those or they didn’t take itall. It’s really destroyed my self-esteem and I’m just looking for something anything to help correct this issue. I would love to find somebody in my area but it’s hard to go to an office because you don’t know who’s reviews are truly honest. If you know anyone in the Portland area please help.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. When administered by a skilled injector, dermal fillers, and facial fat transfers are excellent options for treating under-eye hollowness. However, if you’re interested in more long-term results, lower blepharoplasty can correct this issue by removing excess skin, tightening loose muscles, and repositioning fat below the eye to add volume and create a firmer, more youthful appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They’ll be able to discuss your concerns with you and answer any questions you may have to help you decide on the best approach.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Camille Cash, MD · Answer

From your photos it appears you are a candidate for a lower blepharoplasty.  You could also consider fillers if you are wanting a nonsurgical route.  HA fillers are commonly used in this area to improve hollowness.  You may benefit from cheek filler as well to help unify the contours.  HA fillers are dissolvable with the enzyme hyaluronidase if you do not love the results.  See an expert injector near you to learn more.

C. Blake Perry, MD · Answer

You would be a great candidate for lower lid blepharoplasty with fat transposition. This procedure utilizes an incision from the back of the lid and moves fat into the hollow of the tear trough to give a smooth transition from the lid to cheek. Best to see an eyelid specialist.

David K. Isaacs, MD, FACS · Answer

You appear to have prolapsed lower fat bags, a deep tear trough, and a flat mid-cheek. This combination is likely making you feel you have severe undereye hollows.

A Lower eyelid blepharoplasty utilizing a hidden incision approach through the inside of the eyelid with fat repositioning can help address your issues.

I would also consider facial fat transfer. As the Course Director for the Academy’s Fat Grafting course for many years, there are nuances in fat transfer and it has to be done very carefully. You can alternatively opt for fillers for additional volume.

See an Oculoplastic surgeon for a proper evaluation and recommendations.

What will correct my under eye hollowness? (Photo)

Answers (5)

Answer: Lower eyelid bags

Answer: Lower eyelid bags

Answer: Undereye Fat Bags, Hollows, and Flat Midface

Answer: Undereye Fat Bags, Hollows, and Flat Midface

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What will correct my under eye hollowness? (Photo)

Answers (5)

Answer: Lower eyelid bags

Answer: Lower eyelid bags

Answer: Undereye Fat Bags, Hollows, and Flat Midface

Answer: Undereye Fat Bags, Hollows, and Flat Midface

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.