How can the depression under my eyelid (but above tear trough) be filled & why doesn't it show up in soft lighting?

Question

I have been getting filler to lift my cheeks to fill in my tear troughs. However, recently, I noticed the filler was no longer correcting the hollowness under my eyes. I am now dealing with the sinking in of my eyelid above the tear trough. What can be done about this? Can filler be placed there? Do I need a SOOF lift? It is very dark in the hollowness, like there is no fat there. I have included several photos of myself/the depression and what I would like my under eye to look like. Also, Why does the darkness under my eyes show up under fluorescent lighting, but not in soft lighting? In soft/natural lighting, there is no hollowness under my eyes. When I step into fluorescent lighting, my eyes are very dark. What does this mean and what is the best approach to deal with the hollowness? Thanks.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Lower eyelid fat grafting can help recontour the lower eyelids and tear trough so as not to make it so hollow in natural light.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Ajaya Kashyap, MD · Answer

Thank-you for your query. Fluorescent lighting produces shadows differently from soft, regular lights. If the shadows bother you a gentle filling with one of the lighter hyaluronic acid fillers can help as can a very careful injection of nan-fat. I would not recommend a surgical lift at this time. Please discuss your concerns with your Board certified Plastic surgeon who can address all your concerns. All the best !

How can the depression under my eyelid (but above tear trough) be filled & why doesn't it show up in soft lighting?

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