There are a few options to correct this problem. However, it is important to seek out a well-trained, experienced cosmetic surgeon who deals with problems like hollow eyes on a regular basis. Often times it is the loss of fat from the mid face and around the upper and lower eyelids and even the brow that contributes to the sunken or shallow appearance. Most hollowing eyes can be treated with synthetic fillers or even better, your body's own fat cells. Lower eyelid surgery (lower blepharoplasty) may also be needed if the problem is a deep tear trough with an overlying protruding lower eyelid fat pad.
The most simple solution is often using fillers to fill the tear trough area with a hyaluronic acid product such as Restylane or Juvederm®, which can soften or smooth out hollows. Although the results are not as natural as fat with these fillers, this is an option for patients not ready for surgery. The procedure is non-surgical and is injected along the tear trough region. Results typically last 6-9 months. There can be minor bruising that will usually resolve in less than a week.
Many surgeons, however, will often recommend eyelid surgery to try to correct hollowness under the eyes. "Most of the time, surgery alone does not solve the problem," said Dr. Nease. "Adding fat back to the face eliminates the problem in about 80% of the patients I see, which is less invasive than having eyelid surgery where skin and/or fat is removed. And the fat transfer procedure achieves a much more natural, youthful result."
In cases where there is significant excess eyelid skin or bulging fat pads, we recommend lower eyelid surgery. This is less commonly recommended than other treatments yet still has less than a week's downtime. The technique at Southern Surgical Arts includes minimal scarring as well, often done without any scarring or sutures.