What Are Under-Eye Hollows? Causes and Treatment Options
An under-eye hollow is a sunken, shadowed area at the junction between the under-eye area and the cheek, and it can make the face look tired. This article explains why under-eye hollows form, how they differ from dark circles and eye bags, and what the treatment options are.
Why Do Under-Eye Hollows Form?
- Loss of fat tissue under the eyes and in the cheek area with age
- Thinning of the skin under the eyes and loss of elasticity
- Genetics and the structure of the cheekbone area
- Rapid weight loss
- Factors that wear the skin, such as sun exposure and smoking
How They Differ From Dark Circles and Eye Bags
An under-eye hollow is related to volume loss and becomes visible as a shadow, especially in light coming from above. In dark circles, colour change is the main feature; visible blood vessels under thin skin or darkening of the skin colour can cause them. Eye bags are a puffiness caused by the fat tissue around the eye pushing forwards. These three conditions are treated differently, and they can sometimes occur together in the same person.
Treatment Options
Which method is suitable depends on the cause and degree of the hollow, skin quality and whether there are bags:
- Under-eye filler: the hollow area is supported with a suitable filler containing hyaluronic acid. Because the skin under the eyes is thin, it is applied in small amounts with a careful technique.
- Fat transfer: fat taken from the person's own body is processed and transferred to the under-eye and cheek area; it can be performed alone or together with surgery.
- Lower eyelid surgery: in people with marked under-eye bags and excess skin, the fat tissue can be repositioned or removed. In these cases, filler alone may not be enough and may make the bags look more prominent.
- Cheek support: if the hollow is accompanied by volume loss in the cheek area, filler in the cheekbone area can soften the transition.
Creams, cold applications, adequate sleep and sun protection can contribute to the general appearance of the skin, but on their own they do not correct a hollow caused by volume loss.
Limits and Risks of Under-Eye Filler
The under-eye area is one of the areas that require care among filler treatments. If the filler is placed too superficially, a bluish tint may show through the skin; if too much is injected or the person tends to have under-eye swelling, prolonged swelling may occur. Other possible risks are bruising, irregularity, infection, an allergic reaction and the filler material blocking a blood vessel. Fillers containing hyaluronic acid can be dissolved with the enzyme hyaluronidase if necessary.
If increasing pain, whitening or purplish discolouration of the skin, a vision disturbance or eye pain is noticed after the procedure, a doctor or the nearest emergency department should be contacted without delay.
Recovery and How Long It Lasts
Swelling and bruising may occur for a few days after under-eye filler. In the first days, it is recommended not to press on or rub the area, and to wait for the period recommended by the doctor before saunas and intense exercise. How long the filler lasts depends on the filler used, the amount and the person; with fat transfer and surgical options, results last longer. For more information, see our under-eye light filler and eyelid aesthetics pages.
Author: Op. Dr. Yücel Sarıaltın