I want to remove my under eyes hollows. What treatment would you recommend? (photo)

I want to know the safest way to remove my under eye hollows. I have tried makeup, but I want a more permanent solution. Thank You!!

Doctor Answers 9

Under Eyes

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Your under eye hollows are caused by bulging lower eyelid fat and a flattening of the lower orbital area just below the fat bag of the eyelid. This is a common presentation and is what I would usually see with someone wanting to treat the "aging" of the lower eyelid. It is nicely treated with a lower blepharoplasty procedure that corrects the fat bag and tightens the lower eyelid skin. As with most patients, there will likely still be some hollowness. Fat grafting works extremely well in this area, correcting the hollowness, to give you a smooth transition from the cheek onto the lower eyelid. The fat grafting is done at the same time as the blepharoplasty. Fat grafting may not last in some areas of the face, but in this lower eyelid area our experience is that the grafted fat does not go away, giving years of improvement.

Options for dark circles

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There are various treatments possible including filler injection or fat injection into the hollow area (dark circles) vs lower blepharoplasty with fat repositioning (the fat from puffy area is moved into the hollow area).  See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Under eye hollow treatments

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Hello and thank you for your question.
In my experience, fillers are the best way to go to correct this. There are a few on the market, and your injector can advise on the most appropriate ones for you. The results are usually very very satisfying, although temporary, but most of the patients in my clinic in Sydney accept this

I do not use aft injections at this stage, as I have found the results too inconsistent and variable. This too, is a temporary technique. Depending on your surgeon, usually more expensive.

I wish you well in your search. 

Under eye hollow treatments

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You have multiple options as you have read- the quickest and probable least expensive would be to place an HA type filler in the hollow area- my preference is belotero, you can see pictures on my instagram DrMadnani. You will see a picture during treatment, there is no downtime and results are immediate. 

Other more permanent option would be to have a surgical procedure which would remove the fat from under the eye and placing fat in the ear trough area- there are different ways this can be done, either with a 'transposition' or a 'fat transfer' via a transconjunctival approach, so no incisions are seen on the outside. You are looking at about a week of recovery, with some residual swelling after which you will see some nice results. Full healing takes longer but the results will last a lifetime. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

I want to remove my under eyes hollows. What treatment would you recommend?

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I prefer using Belotero-Balance HA filler injections in the micro injection techniques now being offered by a few surgeons... 

Open composite fat grafting is my preference to treat Hollow eyes

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Thank you for your question.  Based on your photographs I would recommend Open composite fat grafting through a trans-conjunctival blepharoplasty incision.  In addition because of the folds and wrinkles I would also recommend a skin pinch blepharoplasty with Orbiculopexy to tighten the muscle.

Fat injection causes lumps and bumps.  Filler injections are temporary and often not done properly so that visible gray lumps can be seen.  For more information on treatment of Hollow eyes please read the following link:

Under eye hollows

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Injections with facial fillers like restylane while not permanent can help soften this area.  Some will use fat but fat may leave lumps if not placed perfectly.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Under eyes hollows?

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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, micro-fat grafts, and blepharoplasties. There is no one best procedure. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

Following the advice of anyone who would presume to tell you exactly 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 22 reviews

Under eye hollows

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You do have a deep tear trough. You also have some prolapsed orbital fat in the lower lid which casts a shadow over the tear trough making it look even darker.  If you put some filler into the tear trough will help to
 decrease the darkness here.  A more permanent solution would be some sort of a blepharoplasty.  If you have the fat repositioned into the tear trough you will get a smoother  transition from cheek to lower eyelid. From the pictures, you might also need a fat transfer, where fat is taken from elsewhere, to fill in the hollow.  This would be easier to determine with an in person consultation than just with photos.   An oculoplastic surgeon who does fat transfer and fat repositioning would be a good person for you to see.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 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.