How to fix my hollowed eyes and bags under eyes? (Photos)

Doctor Answers 8

"hollow" eyes and bags under eyes

Dear Courtney,

It appears from your photos that you have fullness before lower eyelid fat pads pushing through the skin in the lower eyelid region.

This can happen with age or sometimes at birth. 

Options could include surgical removal or transposition of the lower eyelid fat pads for a more definitive correction.

Fillers can be used but often look unnatural in the lower eyelid region.

I hope this was helpful.


Tampa Oculoplastic Surgeon
4.3 out of 5 stars 32 reviews

Filler

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

Hollowed eyes and bags under eyes

Thank you for your question Courtney.  Based on the pictures provided, you would likely be an excellent candidate for lower eyelid blepharoplasty to remove the lower eyelid bulges.  The "hollow" area between the upper cheek and lower eyelid, such as the tear trough, may also be addressed using a hyalurinic acid dermal filler to "soften" the area resulting in a natural and smooth contour.  Good luck!

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon

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Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

Circles can be treated with lasers, fillers, microneedling/PRP and skin care. Please see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
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The current state of the art treatment for this is under eye fillers by an expert injector.

Put you finger on top of your "bag".  What you are feeling is your bony orbital rim.  You do not have herniated orbital fat which is the stuff we operate on when we do lower eyelid surgery.  Trust me, we do not chip out the bone.  Problem is that many, many surgeons who should know better do not understand that fat is not the only thing that can look like a "bag".  When you are a hammer, the world looks like a nail.  For many years, under eye fillers will beautifully fill in this circle.  Treatment it very technique dependent and finding an expert injector can be challenging.  I know because I have patients who fly from London, New York, and Dubai to have this treatment with me and I assure you if they could find good treatment locally, they would not be flying to Los Angeles for my care.  Don't talk yourself into surgery.  I believe that will be a decision you regret.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Eyelid Surgery

Thank you for your question. Eeyelid surgery is common for removing under-eye bags that can develop while fillers are suitable for increasing the volume in hollowed eyes. Please consult with a board certified facial plastic surgeon during an in-person appointment. Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

How to fix my hollowed eyes and bags under eyes?

Hello CourtneyMcCann,There is naturally fat found around the eye.  In some patients, the membrane that holds them back is weaker than in others as a result of genetics or age.  This allows those bags to show through more.  This then accentuates the area below the bags, known as the tear trough, and makes it look deeper and more hollow.  There are several options to help.  The first option is simply using makeup to help camouflage the area.  With time, more is needed and it starts to cake.  The next option is to camouflage it.  The hollow below the bag draws more attention because of the shadow cast by the bag above.  By using fillers (I like Restylane) to elevate the tear trough, it softens the shadow and makes the bag less noticeable.  The third option is to go at the root cause of the bag.  This involves surgically removing the fat.  Based on your photos, I would imagine the approach through the pink part of the eye (called transconjunctival) would work for you.  This does not have any external incisions and can address the fat bags below the eye.I'd recommend you consult with a facial plastic surgeon to go over your options, learn the pros and cons, and determine which is right for you.I hope this helps and good luck.    

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Lower eyelid bags

From your pictures, it appears you have mild prominence of the lower eyelid fat compartments, which is what causes the lower eyelids to look a little full and "puffy." It appears the skin texture/tone of the lower eyelids is good. You may be a good candidate for a transconjunctival (incision from within the inside of the lower eyelid) blepharoplasty with removal of some of the prominent fat. This will result in a much smoother appearance of the lower eyelid. If you have some hollowing under the eyelids ("tear troughs"), this can be addressed at the time of surgery by re-positioning some fat into the area. This can also be managed post-operatively with hyaluronic acid fillers like Belotero and Restylane. 

Katherine Zamecki, MD, FACS
Danbury Oculoplastic Surgeon

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.