How can I get rid of the indentation around my eyes?

Question

How can I get rid of the indentation around my eyes? i previously had filler injected under my eyes, but unfortunately all the filler migrated down my cheeks and my eyes became sunken

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear you've had this experience. The under-eye area is one of the most delicate regions of the face, and while filler can produce beautiful results in the right patient, it can also be challenging because the skin is so thin and the anatomy is complex.

If your previous filler truly migrated below the under-eye area and into the upper cheeks, the first step is determining whether any filler is still present. In many cases, what appears to be "migration" may actually be filler that has shifted slightly, retained water, or become more noticeable over time. An experienced injector can often assess this during an examination, and in some cases, imaging such as ultrasound can help identify where the filler is located.

If there is excess hyaluronic acid filler remaining, dissolving it with hyaluronidase is often considered before adding any new filler. This allows the area to return to a more natural baseline and helps avoid layering additional filler on top of product that may already be present.

Once the previous filler has been addressed, the best treatment depends on why the eyes appear sunken. Some people have a true tear trough deformity caused by genetics or age-related volume loss, while others have volume deficiency in the cheeks that makes the under-eye hollow appear more pronounced. In those cases, restoring support to the midface rather than injecting directly into the tear trough can sometimes produce a more natural improvement.

For patients with significant hollowing, autologous fat grafting may also be considered. Because it uses your own fat, it can provide longer-lasting volume, although results can vary depending on how much of the transferred fat survives.

It's also important to remember that not every under-eye indentation should be treated with filler. If the skin is extremely thin, there is significant skin laxity, or the anatomy is not favorable, filler may increase the risk of lumpiness or recurrent migration. In those situations, other approaches may provide a better long-term outcome.

Based on your history, I would be cautious about simply adding more filler without first evaluating the existing product and identifying the true cause of the hollowing. A careful, stepwise approach usually provides the safest and most natural-looking result, especially in such a delicate area.

How can I get rid of the indentation around my eyes?

Answers (1)

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