What is the Best Treatment for Hollow Eyes on an African American Woman?

I am a 47 yr. old African American woman with deep hollow eyes. I have pronounced cheek bones that were once attractive; my face now has a skeletal appearance. I have read very disturbing information regarding adverse affects of injectble fillers and am wondering what options are available to me. My appearance has limited my social interactions because I feel unattractive and embarrassed. I reside in NYC and would like to meet with a doctor who can help me reverse these visible signs of aging.

Doctor Answers 4

Fat Grafting to eye hollows

Take a look at the eyes of fashion models in advertisements: in most cases you actually see little to none of the upper lid.  What you see is a youthful soft tissue fullness that extends from the brow to the upper lid lashes. As we age, this fatty fullness atrophies and the brow-upper lid junction gradually becomes hollow.  The outline of the bony structures below the brow (the superior orbital rim) becomes visible, and one begins to look older, sometimes even ill, and in advanced stages even skeletal.  In some patients that I treat this appearance is inherited and they have a hollow look at their brow-upper lid junction at a young age.  It is also an appearance that some people have following an overly aggressive upper blepharoplasty, where the surgeon inappropriately removes fat from the brow-upper lid junction.

Unfortunately, this is a result that quite a few patients get from upper blepharoplasty, and I treat a significant number of these patients who need that fatty fullness restored between their brow and upper lid. Whether hollowness at the brow-upper lid junction is something that was always present, something that has developed with aging, or something that resulted from an overly-aggressive upper blepharoplasty, fat grafting of the brow-upper lid junction can rejuvenate the eye area in a manner that is simply impossible by means of standard blepharoplasty techniques.  It does not look like ‘surgery’, and patients for whom I perform this procedure return to say that their friends and acquaintances think they look great, but they can’t quite put their finger on why.

A word of caution: this is a delicate surgery that requires a significant amount of experience with fat grafting, careful preoperative evaluation, and meticulous surgical technique.  In experienced hands a youthful and aesthetically ideal brow-upper lid contour can be achieved.  Make sure your surgeon can show you numerous photographic examples of brow-upper lid junction fat grafting. .

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Hollow eyes

Without examining you it is difficult to say what would be best.  However, fillers can sometimes be helpful to fill the cheeks as well as the hollowness under the eyes.  Even lower eyelid surgery  may help with deficiencies or excesses.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Your deep hollow eyes may benefit from an Injectable Filler treatment.

Hollowing of your lower eyelids is commonly treated with injectable fillers. You should consult several board-certified dermatologists or facial plastic surgeons experienced in the art of filling this delicate area. My personal preference is Silikon-1000 for permanent results.

Feel free to email your photo along with a description, and I'll be happy to share my thoughts with you.

I hope this is helpful for you

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Fillers vs. autologous fat

Your case scenario sounds optimal for fillers. If you are afraid to use off the shelf fillers liposuction from elsewhere & injection of this fat into your face is your best option. You could also use a filler that is less doctor dependent and does not last as long. In that case you should go slowly and not have it all injected at one time.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.