Under Eye Hollows

Dr. Brock Lanier, MD, FACS  |   OncoPlastic Surgery in Newport Beach

What Causes Under-Eye Hollowing?

Anything that causes volume loss or skin thinning in the under-eye area can contribute to hollowing.

Aging:

As we age, we naturally lose collagen and elastin, which are proteins that keep our skin firm and elastic. This loss leads to thinning skin and a decrease in facial fat, causing the under-eye area to appear hollow.

Genetics:

Some people are genetically predisposed to having deeper tear troughs or thinner under-eye skin. This means that under-eye hollowing can run in families.  

Dehydration:

When the body is dehydrated, the skin loses its plumpness, which can make under-eye hollows more noticeable.  

Lack of Sleep:

Insufficient sleep can cause the skin to appear dull and the blood vessels under the eyes to become more visible, emphasizing the appearance of hollows.  

Weight Loss:

Significant weight loss can result in a loss of facial fat, including the fat pads under the eyes, leading to a hollowed appearance.

 Sun Exposure:

Excessive sun exposure can damage collagen and elastin, accelerating the aging process and contributing to under-eye hollowing.  

Smoking:

Smoking also damages collagen and elasin, and contributes to premature aging of the skin.

Treating Under-Eye Hollows

At our medical practice we get a lot of questions about the best way for treating those under eye hollows. You should be an individual - and get a personalized assessment by a board-certified plastic surgeon.

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Under-Eye Hollows:

treatment options at a glance

  • Hyaluronic acid-based fillers (e.g., Juvederm Volbella) are injected into the tear trough area to restore lost volume, smooth transitions, and reduce shadowing under the eyes. Results are immediate, predictable, and last 6 months to 2 years depending on the product used. The procedure is quick and virtually painless, with minimal downtime.

  • Also known as collagen induction therapy, microneedling involves creating microscopic-sized pinpricks in the skin to stimulate collagen and elastin production. This enhances skin texture and firmness, helping reduce the appearance of hollows over time.

  • Chemical peels and laser facials exfoliate the outer layers of skin, improving texture, reducing pigmentation, and stimulating collagen production. This treatment brightens the under-eye area and enhances overall skin quality.

  • SkinTyte uses infrared light to heat the dermal layer of the skin, stimulating collagen production and causing collagen fibers to contract. This process tightens and firms the skin over time, improving sagging and fine lines. It is non-invasive, painless, and requires no downtime, making it suitable for delicate areas like the skin around the eyes. It is safe for use on the sensitive area around the eyes, but not typically applied to the eyelids themselves.

  • Topical treatments and eye creams containing ingredients such as hyaluronic acid and vitamin C can improve skin hydration and texture decreasing the laxity and also minimize discoloration. Topical hyaluronic acid is the same substance as the dermal filler. It can hold and lock-in a lot of water, more than a hundred times its weight of water. That’s why hyaluronic acid is a hydrator, rather than simply a moisturizer. This is important but it can really plump and thicken the skin around the cheek and eyelid junction where the hollows form.

  • Adequate hydration, balanced nutrition, sun protection (e.g., sunscreen), and sufficient sleep can prevent worsening of under-eye hollowing over time.

  • Surgery with an eyelid lift can simultaneously address all the causes of under eye hollowing - both skin tightening and under eye volume loss. It is a long-term solution. It is typically reserved for significant under eye hollowing. It is a is a surgical procedure, done as an outpatient (you can go home same day), with recovery time typically lasting 1.5–2 weeks.

Our practice, SoCal OncoPlastic Surgery, offers all of these options. We specialize in individualized evaluations in oder to avoid one-size-fits-all approaches. The most important thing is to get expert advice from a board-certified plastic surgeon.