What's the best treatment for under eye hollows without using a filler? (photo)
Doctor Answers 14
Lower Eyelid Dark Hollows
Fat grafting or Belotero not laser treatments are best for under eye hollows
Thank you for your question and photographs. Personally I do not use fillers to correct depressions beneath the eye lid. From your photographs it appears that you have some excess fat causing puffiness which creates a shadow beneath the eyelid. In my experience a blepharoplasty procedure called arcus marginalis release with fat grafting is the most successful permanent solution. Fillers can be used but only if done by an expert eyelid surgeon and only if Restylane or Beletero is used.
Choose your Dr. very carefully and insist on seeing a board certified plastic surgeon or oculoplastic surgeon. I have seen many patients who had filler injections beneath the eyelid who had visible gray lumps and were very unhappy with the results.
TearTrough Deformity Management
It's not unusual for patients with tear trough deformities to request plastic surgical consultation. When this situation arises, a variety of treatment options exist to treat this condition. These include surgical procedures that release the arcus marginalis and reposition fat, fat injections and hyaluronic acid filler injections. Each of these approaches offers advantages and disadvantages.
It's extremely important to individualize the treatment of tear troughs. For this reason, the specific procedure chosen will depend upon the patients anatomic findings and aesthetic goals. It's note worthy that your pictures demonstrate the presence of fat pads.
It's important to realize that lower eyelid filler injections are very effective for treating tear trough deformities, but don't provide a permanent solution to this problem. When a permanent solution is desired, fat injections may be an acceptable alternative.
In someone like yourself with prominent fat pads, arcus marginalis release with fat re-positioning is probably the best treatment option. The procedure is associated with excellent clinical results.
It's important for patients with tear trough deformities to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.
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Fat Grafting or Blepharoplasty May Help
A lower lid blepharoplasty (eye lift) can surgically release the muscle from the bone. If there is enough fat, it can be rearranged, but in your case adding some fat under direct vision during the blepharoplasty could be very beneficial. You need to see your surgeon to discuss these issues. Best wishes.
What is the best treatment for under eye hollows without using a filler?
The photographs demonstrate herniated fat and lower lids creating the puffy look. It is best to seek evaluation by a physician, not a nurse for any surgical treatments on the lower lids. A trans conjunctival approach lower blepharoplasty can accomplish removal of those fat pads creating the puffy look and getting rid of the double bubble appearance. For many examples, please see the link and the video below
Filler for under eye hollowing
Filler is the best treatment for under eye hollowing and from your photos I feel that you are a good candidate. Common fillers used under the eye include Restylane and Belotero. Volbella is a new filler on the market and I have had excellent results using it for the lower and upper lids.
Laser, Fat or blepharoplasty
Great question. I disagree with your nurse. I think fillers can help. That being said fat is even a better grafting material. In my hands the best results are with a combination of lower lid blepharoplasty with fat transposition and fat grafting.
I also like laser for this problem but the results are modest. To make most patients and myself completely happy with the results, a combination of procedures is often required. I have done fat and laser only on patients adverse to surgery. The results are good. You volumize with the fat and then tighten the skin with the laser. Depends on age, skin type and exam to see whether or not you have prominent fat pads etc.
Hope this helps.
Best of luck,
Fat Grafting for under eye hollows
Best Way to Deal with Eye Hollows
Options for under eye hollows
You should see a surgeon who has experience in both eyelid surgery and filler treatments to the eyelid/cheek area in order to determine what options are best fit for you. Cosmetic eyelid surgery (blepharoplasty) can help remove under eye bags by either removal and/or repositioning of the the excess fat pockets. Filers to the eyelid/cheek can help improve the under eye hollows and dark circles. Both are options that can provide excellent results in the correctly selected patient. Good luck.