How can I reduce the appearance of sunken eyes? (Photo)

Question

Hello! I've had sunken eyes since I was around seven years old due to genetics and the hyperpigmentation seems to get darker with age. My mom is darker, so the hyperpigmentation is not as noticeable on her. Is the only option to get filler? Could fat removal around the area help it appear less sunken in?

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Restylane is a great product to use in the tear trough area.  It allows us to fill the sunken in look and helps a bit with the pigmentation.  Depending on if you have a prominent fat pad, yes a lower bleph would be the more permanent treatment for this problem.  I would suggest speaking to a Board Certified Plastic Surgeon in person to discuss your options.  Best of luck to you.

John Diaz, MD · Answer

Filler, PRP injections or lower blepharoplasty surgery are all options that can be used to treat this area. Seek a consultation with a provider to see what the best treatment plan is for your individual case.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Nima Shemirani, MD · Answer

Hi @throwthisaway! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area. Another option would be PRP injections. PRP which stands for Platelet Rich Plasma is a natural and non-surgical solution to treat under eye circles and bags. PRP is highly effective for restoring sunken eyes.  Generally, two vials of blood will be collected from the patient and placed into a centrifuge. The centrifuge spins and separates the platelets from the rest of the blood components. The plasma contains the valuable collagen and growth factors from the rest of the blood's components. The plasma is then drawn up into a syringe and injected in the tear trough area. Typically, 3 sessions is adequate for optimal results.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. It is difficult to determine the exact problem from the photo, but it sounds like proper placement of fillers in conjunction with erbium laser resurfacing could be beneficial. Make an appointment with an experienced oculoplastic surgeon for in-person evaluation and guidance. Good luck!

Marc Polacco, MD · Answer

Thank you for your question. This is a very common concern. Depending on the patient and individual goals, I usually recommend a conservative amount of filler as a place to start. Often this can attain a rejuvenated, well-rested appearance. In patients who seek a more permanent solution, lower blepharoplasty with fat transposition is often effective. I hope that's helpful, and all the best!
-Dr. P

Camille Cash, MD · Answer

Fillers work well to correct hollow areas under the eye.  The volume helps to smooth contours so they are more harmonious with the rest of the face.  See an expert injector near you to learn more.  I've included a video on this topic that I hope you find helpful.

Elizabeth Wick, MD · Answer

Thank you for your question. The shadowing in your picture makes it difficult to speak to your specific anatomy. 
In general, eye rejuvenation can be broken down into three categories that include:1. topical treatment of discoloration or fine lines2. HA filler (Restylane vs. Volbella) to smooth and hide undereye hollows that become more obvious as skin and fat layers become thinner over the muscles and ligaments around the eyes3. surgical correction of undereye hollows and fat herniation
I like Epionce and Alastin products for topical treatment of the eyes. Epionce has two topical treatments that are more effective when used together, but can be used independently to specifically target dark circles (Luminous Eye Serum) vs. fine lines (Renewal Eye Cream).

Dean P. Kane, MD, FACS · Answer

Dear throwthisaway,

Thanks for sharing your photo. The single static perspective and the black-outs limit a opinion. You will need a in-person evaluation. 
Sunken eyes maybe truly deep in the skull’s orbital socket or they maybe an illusion as you mentioned due to pigmentation, shadowing from the orbital roof and cheek projection or associated with sagging of the brow and eyelids. 
For this reason, obtain consultion with a Board Certifed Plastic Surgeon or Oculoplastic Surgeon with talent in minimally invasive and non-invasive options. Consider:
•	A certified ZO Skin Health Team to offer proper retinoid texture control, hydroquinone pigment control, laser and peel improvements.
•	Skillful injection of “botox” (or other injectable muscle relaxers to elevate the brow and open the eyelids
•	Fillers to artfully reduce shadowing by filling in under-eye hollows and troughs.
I hope this has been helpful. All the best!

Darryl J. Blinski, MD · Answer

Best to use HA fillers in your "sunken eyes" areas or tear troughs. Then after 1-2 weeks post HA fillers have a TCA peeling of lower lids or slightly stronger peel. Fees in the $3,000+ ranges.

How can I reduce the appearance of sunken eyes? (Photo)

Answers (11)

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