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As we age, we lose volume in certain parts of our face while we gain volume in other parts.
When we lose the fat layer along the lower eyelid region and upper cheek, the eyes begin to look hollow. Traditional approaches focus on blepharoplasty or eyelid surgery in which skin, muscle and fat are removed in order to sculpt the eyes.
On a weekly basis we see 2 or 3 patients who feel like their eyes have become hollowed and gaunt looking as a result of fat removal lower eyelid surgery performed years ago.
In patients with more advanced volume loss that extends into the upper cheek region, and beyond the tear troughs, fat transfer is an excellent permanent solution.
Of course, every case is unique and an individualized consultation is required to assess what the best strategy is for you. Medical Disclaimer: Information on this website about rhinoplasty, facelift surgery, blepharoplasty, eyelid surgery and more is not intended to substitute for medical advice or medical treatment. Hollowed under eyes, dark circles and a tired appearance usually begin around the age of 40. Hyaluronic acid (HA) injectionable fillers work like magic in filling the void, rehydrating and plumping the under eyes and instantly restoring younger looking eyes. Because Restylane provides only temporary correction (approximately 9 months) a more permanent alternative may be your next step in treating “sleepy hollowing”.
Under eye bags in young people are usually because of a negative vector orbit, where the orbit of the eye protrudes beyond the cheek bone. You may think your under eye woes are a real horror story, but these solutions for sleepy looking eyes and hollowing can be magically corrected with the above methods. Fat TransferGoals: Full face fat grafting was performed on this woman to restore volume to her entire face. Fat Transfer (Grafting)Goals: Fat grafting around the eyes can rejuvenate the appearance of an old-looking, hollow eyelid. Fat Transfer (Grafting)Goals: Fat transfer was performed to his lower eyelid to improve the appearance of his tear trough.
If you are, the good news is there are several very effective and simple office-based procedures available to address this problem area with little to no downtime.

Generally speaking, the region around our eyes and cheeks begins to lose fat, while the jowls and neck begins to gain fat. The reality is many times the eyes would actually look older and often just different as a result.
I have spent so much time correcting these problems that I now treat eyes in a much more conservative and naturally rejuvenating way.
Be sure to speak to your Plastic Surgeon San Diego personal physician about any health concerns you have and to rely on personal consultation with your plastic surgeon regarding the cosmetic or reconstructive procedures that are appropriate for you.
Under eye hollows can be the result of your anatomy (negative vector orbits) or caused by loss of facial fat with normal aging. At some point, after realizing that concealing makeup isn’t really helping, women start looking for an alternative.
Fat grafting provides this long lasting correction by using your own body fat, retrieved through liposuction and then purified for re-injection. The before and after photographs illustrate improvement in her eyes, cheeks, temples, brows, and jaw line. Notice the more rested, youthful, and natural appearing look achieved with facial fat micrograting alone.
Jacob D Steiger MD is board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology- Head & Neck Surgery. This misses the whole goal of eyelid surgery, which is to make the eyes look refreshed and revitalized. My first choice for treating the hollows under the eyes is Restylane or Juvederm for mild changes in a younger patient (30-40s) This technique is used to fill the tear troughs (cresent-shaped hollows in the corners of the eyes near the nose). This gives the upper face a much younger appearance without making the person look different. Again, be very particular in choosing your practitioner, one experience in fat grafting to the eyes. The implants are safe, made of silicone and are positioned just under the orbit and above the cheekbone to permanently fill the hollow and bring the area into the light. Brian Reagan in 2015, is a comprehensive center focusing on aesthetic plastic surgery and skin care.

As seen in this before and after photo, fat grafting around the eye restores a very natural, youthful appearance. He practices in Boca Raton and Delray Beach, Florida treating patients from Palm Beach, Ft. Many of patients come in telling me that people comment that they look tired when in fact they are not. The fat volume in the upper cheek and around the eyes are genetically predisposed to volume loss.
In our practice, this is an important and highly emphasized sign of aging that we treat on a regular basis. Generally 1 syringe is all that is needed for correction of both under eyes and the cost is roughly $500 for 1 cc. We have been thoroughly inspected and are state licensed and Medicare certified, meeting the highest standards for an ambulatory surgical center. If the patient wants to address the cheeks with an injectable, Radiesse or Sculptra are used in place of fat. Seek an experienced injector for this treatment and ask to see before and after photos before treatment. Gilbert Lee of Changes Plastic Surgery & Spa is a pioneer of fat grafting and performs fat grafting to the under eyes under local anesthetic. We have also passed the close scrutiny of the American Board of Plastic Surgery, which found it to meet their highest ethical standards.
And when it comes to rejuvenation of the eyes this concern is the most common reason people seek help. Restylane is a very forgiving product as it can be easily dissolved, but treating the delicate eye area takes skill.

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