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Even younger patients can have some degree of hollowness under their eyes. This hollowness, if pronounced, may gives the appearence of "fatigue" and "Poor- Health". Sometimes it is present in conjuction with dark circles, fine lines, or unsightly growth.
Many patients believe that surgery is the only option in treating these conditions. That is simply not true.
The Hollowness under the eyes may be secondary to agressive eyelid surgery or simply genetic. Ten years ago surgery or fatgrafting were the only treatments available. Today, with the advent of long lasting fillers, natural looking results are possible and affordable.
I prefer Restylane but have used Juvederm under the eyes. Topical anesthesia is applied, area iced, and minute amounts of the filler placed in layers to build up the hollowness under the eyes. This is usually performed in a sitting position to fully appretiate the anatomy.
Complications are rare. I have had occasional extensive bruising and rare events of irregular application of the filler. Gentle daily massage over 2-3 days usually evens the occasional bumps. If needed, excess filler can be dissolved with injection of very dilute Kenelog (2.5mg/cc--0.1 cc).
The overlying skin can either be peeled with TCA or lasered using a longe wavelengh laser such as Cooltouch.
Results last for 6-12 months and look very natural.
Cost $500-$900; depending on the type of filler used.