What can be done with the hollowness, especially under the right eye? (Photo)

Question

Hi! What can be done with the hollowness, especially under the right eye? I want to avoid fillers and surgery. Is there any other procedures or products that could improve the area?

Anna Chacon, MD, FAAD · Answer

Under-eye hollowness can be frustrating because it can make the face look tired even when you feel completely rested. The important thing to understand is that hollowness is usually a structural issue, so there isn't a cream or skincare product that can truly replace lost volume.

That said, if you want to avoid both filler and surgery, there are still some options worth considering.

First, determine what is creating the hollow

The area under the eyes can look hollow because of several things: natural anatomy, loss of fat or volume with aging, a prominent tear trough ligament, thinning skin, or a combination of these. Asymmetry is also very common, so having one side—such as your right side—look more hollow than the other isn't unusual.

This distinction matters because a treatment that improves skin quality won't necessarily correct a true volume deficit. Current reviews emphasize that under-eye concerns are often multifactorial and need to be matched to the underlying anatomy.

If you want to avoid filler and surgery

PRP or PRF would be one option I would consider. These treatments don't function like a traditional filler, but they may improve skin thickness, texture, fine lines, and overall quality. Studies have shown some improvement in periorbital rejuvenation with PRP, although the results tend to be subtle rather than dramatic, and the evidence is still somewhat variable.

I would set expectations appropriately: PRP/PRF may make the skin look healthier and slightly improve the transition around the hollow, but it won't reproduce the same amount of volume that a filler or fat graft provides.

What about lasers or microneedling?

If part of what bothers you is thin, crepey skin or fine lines, treatments such as fractional laser or microneedling can improve skin texture and collagen remodeling. They are more useful for the quality of the skin than for correcting a deep tear-trough depression.

In other words, if the issue is primarily “my skin looks thin and wrinkled,” these treatments may help considerably. If the issue is “there is an actual depression where there should be volume,” the improvement will be more limited.

I would be cautious about trying to "fill" the hollow indirectly

There are products marketed as collagen stimulators or various injectable alternatives to traditional fillers. Some can improve skin quality, but I would be very selective around the lower eyelid because this is an anatomically delicate area.

I also wouldn't assume that a more aggressive treatment is necessarily better. The skin around the eyes is extremely thin, and over-treatment can sometimes create swelling, irregularity, or an unnatural transition.

What I would realistically expect

If your goal is some improvement without filler or surgery, I would think about this as a skin-quality treatment rather than trying to completely erase the hollow.

A reasonable nonsurgical approach could involve PRP/PRF, possibly combined with a carefully selected resurfacing or microneedling treatment if there is also crepey texture or fine wrinkling. The available evidence suggests PRP can produce modest improvements in periorbital texture and wrinkles, but it is not a replacement for structural volume restoration.

And honestly, a little asymmetry under the eyes is completely normal. If the right side is only subtly more hollow, I would favor a conservative improvement rather than trying to make both sides perfectly identical. The eye area is one of those places where doing too much can sometimes be more noticeable than doing too little.

Camille Cash, MD · Answer

An in person evaluation is best but from the submitted photo it appears you would have the best result from a lower blepharoplasty.  You can consider other treatments such as Morpheus8 or Face/AccuTite that may provide some improvement.  We always recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Leonard Grossman, MD · Answer

The single best way to treat volume loss in the lower eyelid is with the use of fat grafting. When properly done, fat grafting produces natural and practically permanent results. I hope this helps and good luck from New York City Plastic Surgery.

What can be done with the hollowness, especially under the right eye? (Photo)

Answers (3)

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