Early 20’s Male. Under Eye Hollows - should I consider treatment? (Photos)

Question

Hi everyone, I’ve always had somewhat of a hollower under-eye area, and recently I’ve been noticing it looking a bit more sunken. Overall, I’m happy with my facial features and appearance, so I’m hesitant to pursue any treatments if it isn’t truly necessary. I’m curious about whether this under-eye hollowness is something that typically warrants intervention, or if it’s within the range of normal variation. I’d appreciate any feedback or experiences—should I consider treatment, or would it be reasonable to leave it as is? Note to consider: I’m at around 22-24% body fat would lowering down to 15-17% fix most of the droop as the buccal fat in my midface will go down?

Lexie Wang, MD · Answer

As always - you never have to pursue any treatments for aesthetics, so to answer your question of whether it "warrants intervention", you don't need to. Ever.

that being said, it looks like you may have a negative vector eye, either from how you were born vs. aging. you could consider using filler or fat grafting to build up the maxilla/cheek bone to try to smooth that transition (give more volume to the eye socket) to see if you like that.  the body fat issue is a non-issue other than possibly losing more fat in your face could exacerbate/worsen this. the buccal fat has no bearing on this lcoation.

Paul Flashner, MD · Answer

Mild hollows are totally normal at your age. Lowering body fat usually won’t fix them and can even make them more noticeable. If you want a change, under-eye filler with Restylane can help achieve subtle volume.

Please call your nearest Skin MD location to book an appointment with an injector.

Please call your nearest Skin MD location to book an appointment with an injector.

John Luck, MD · Answer

To best address your concern you would want to consider a fat transfer to your periorbital (under eye) region. This would involve obtaining about a marble size amount of fat from another area of the body to be processed into micro fat, which would then get re-injected to the hollow area . This will allow for a nice smooth , more youthful appearance. Typically, under eye filler could make the appearance of any dark circles be a lot more noticeable . A lot of time the fat transfer is also done as part of an under eye blepharoplasty. It is always recommended to be seen in person to get the best possible analysis to see whether or not you would be a candidate both.
Best of luck,Dr J.D. Luck

Nick Slenkovich, MD · Answer

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center.  PRP (Platelet-Rich Plasma) injections are a natural, non-surgical option some people use to improve under-eye hollows and dark circles. They work by using your own blood’s growth factors to stimulate collagen and improve skin texture, helping reduce puffiness and dark circles.

Anna Chacon, MD, FAAD · Answer

What you’re noticing under your eyes is something a lot of people in their early 20s see — some of it is just how your facial structure naturally is. For some, the under-eye area is a little thinner, and that can make hollows stand out more, especially in certain lighting.

Losing body fat usually makes this more noticeable, not less, because the cheeks lean out before the under-eye area changes. That’s why even people who are really fit often still have hollowness there.

The good news is — this is completely normal, and nothing about it means you have to treat it. Many people have a bit of under-eye depth and leave it alone, while others choose a small filler treatment if it ever starts to make them look more tired than they feel. Both approaches are valid.

Since you already feel good about your features, it’s perfectly reasonable to just leave it as is. Think of it as one of those small variations that make a face look natural and real.

John Tang, MD · Answer

Thank you for submitting your photos and sharing your concerns.  Based upon your photos, I would recommend that you consider a filler to help improve the hollowness in the tear trough area (under eye hollowness) and to hide to some degree the area of elevation caused by a small accumulation of fat that lies above the area of hollowness.  We would use a filler like Restylane/Restylane Eyelight which can be injected into this area to smooth out/prop up the area of hollowness.  This has to be done with proper technique by a highly skilled professional to have good results and to avoid complications of uneveniness and a purplish hue in the skin when the filler is injected into the wrong plane.  Hope that helps.  Best wishes!

Camille Cash, MD · Answer

From the photos it appears you would be a candidate for under eye fillers to improve the contour.  You asked if you "need" it.   You are the only one who can answer this question.  I've included a video about fillers that I hope you find helpful.

Stefan Weiss, MD · Answer

If under-eye hollows bother you, dermal fillers can help correct them by adding subtle volume. This treatment minimizes shadows and creates a refreshed, more youthful appearance.

Leonard Grossman, MD · Answer

I would not consider anything else, but fat grafting. With fat grafting, you can get results that only you can desire. I generally have my patients either drawer or use computer, enhanced photographs to create an image you would like to achieve. Over the last 30 years I’ve never had a patient who was unhappy with fat grafting to the face or anywhere else on their body. I hope this helps and good luck from Leonard Grossman M.D.. organic Plastic Surgery in New York City