Best Fillers To Treat Hollow Under Eyes

several issues that people undergo under the eyes, ranging from the presence of deep tear troughs, under eye bags, and hollowness. The area under the eyes may be hollow due to various reasons which include some genetic reasons, aging effects caused by volume loss, or from other health or environmental faces like extreme exposure to the sun, or from cigarette smoking and other habits that affect both the internal and extra skin. If you have hollow eyes, it can affect the whole area under the eye to the upper regions of the cheeks, or the tear trough which is the small region that is below the eyes.

Hollow eyes treatment

Hollow eyes can be treated effectively with a soft hyaluronic acid filler like Restylane Silk, Restylane, or Juvederm Ultra. There are many more fillers being developed today which patients are also free to choose from. The most appropriate filler is the one that is softer because the lower eyelid skin has a thickness of 0.5mm, and it moves flexibly with the facial expressions. When facial implants or thicker fillers are used, they can affect the appearance of the eyes.

The whole process of placing the filler can be done within minutes. The injectable fillers we have looked at above can last for about 4 to 6 months, depending on how each patient metabolizes the material. The most common material used in modern cosmetic fillers is the hyaluronic acid; it is naturally occurring in the body, and it can be metabolized over time safely, and it is hypoallergenic.

The best part about using a hyaluronic acid filler is that the procedure can be reversed if need dictates. An enzyme called hyaluronidase can dissolve the hyaluronic acid for a complete reversal to happen.

Use of PRP (Platelet Rich Plasma) for skin thickness and discoloration

Dr. Andres Bustillo usually combines the use of a cosmetic filler and PRP under the eyes to improve the skin color, volume, quality, and to extend the filler effect. Platelet-rich plasma is deduced from the blood of the patient, it is then passed through a centrifuge for the separation of red blood cells, and the plasma concentrate which is harvested has several growth and healing factors that are important to heal wounds and cuts.

The plasma concentrate stimulates the formation of new blood cells, collagen, it improves blood circulation, and it also improves the skin volume and thickness. PRP improves the health and quality of the skin of the lower eyelid affected by issues of pigmentation and deposits of iron that cause discoloration.

Cheeks can cause under eye hollowing

Some cases of symmetry between the two sides of the face and hollowness under the eyes may not be because of tear troughs, but from the deficiency of volume in the upper cheeks. There can be a volume difference present on the upper cheeks from the asymmetry that is on one side of the face compared to the other, or from the loss of volume because of aging. In these cases, volume addition using a filler at the tear trough might be ineffective, and it can be problematic because there is no “shelf” to support the volume from the upper cheek.

The deficiency in volume on the upper cheek can be treated differently compared to the tear trough. Skin that is located on the cheek is thicker than the thin eyelid skin, and a more rigid bone backs the cheek. Thicker hyaluronic acid fillers like Juvederm Voluma and Juvederm Ultra Plus can work on the cheeks because they last longer for up to between 1 year for Ultra Plus and 2 years for the Voluma.

The technique used to place fillers

There is a specialized technique known as the Y Lift or Structural Volumizing that is used to place fillers at the cheeks and other areas of the face. Structural Volumizing places Juvederm Ultra Plus or Juvederm Voluma which are long lasting fillers to the bone level to provide a good volume foundation. This is different from the fillers that are placed in soft areas which do not support the filler’s weight. If this filler is used in the soft tissue, it results in the filler weighing down the face, leading to a pillowy or doughy appearance. Since the bone is a strong foundation on the face, and it is held in position by the facial muscles, the use of Structural Volumizing adds youthfulness and definition to the natural-looking results.

How fillers take effect on the under the eyelids

If you ask Dr. Andres Bustillo about fillers, he always recommends that 1 or 2 under-eye fillers are good enough for great results to be witnessed; but it also depends on the type of skin, age, and lifestyle. But most people say that the effect of the treatment is seen after 6 to 8 months.

Additionally, there is another under-eye filler that is used for hollows, and it is also known to work well; your body fat. In this process, your fat is sourced from an area where you have excess fat, like your thighs. After it is collected, it is injected to your under-eye area.

Although fat grafting is not predictable, it can stay for several years. Although this is the case, it is not the best procedure that patients can have.

Results of a filler procedure

When the procedure is complete, the face and the eyes tend to look brighter and awake because the filler corrects the hollowing under the eyes. It is not a cheap process as it costs around $800, depending on the quantity of filler being used. Since hyaluronic acid is a naturally occurring filler, its effect is not permanent. It gets metabolized after some time.

For more information regarding the best fillers for sunken hollow eyes, contact Dr. Andres Bustillo, M.D. at his office in Miami, FL.


  1. July 3, 2018 / 00:13

    I have eye bags, and i am unhappy. I will have a try for your tips