Under-eye hollow causes
Under-eye hollows occur when soft tissue depth between the orbital rim and tear trough diminishes due to aging, genetics, and facial structure. In many individuals, fat loss under the eye makes the under-eye area appear sunken and can cast a shadow that reads as dark circles. Bone resorption in the orbital rim also contributes to a deeper tear trough, especially after middle age. Early signs vary and can be influenced by hydration, sleep, and sun exposure, but structural change is the core driver.
Common patterns include a pronounced tear trough, lid-cheek junction flattening, and a hollow that extends toward the inner eye. Genetics often dictate the baseline, while aging accelerates sagging skin and fat redistribution. Differentiating hollow from fatigue or pigmentation helps tailor the treatment plan. A dermatologist or oculoplastic expert assesses skin thickness, tear trough depth, and eyelid laxity.
A well-rounded evaluation considers eye balance with surrounding features to avoid overcorrection. Imaging is rarely necessary, but a careful physical exam reveals whether a primarily surgical or injectable approach is appropriate. In Korea, clinicians frequently combine methods to address both hollow and lid-cheek junction without compromising natural expression. Understanding the underlying cause helps patients set realistic expectations for recovery and results.
Under-eye filler options
Fillers provide immediate improvement by restoring volume in the tear trough and at the lid-cheek junction. Hyaluronic acid fillers, including branded products like Juvederm, are commonly used for their smooth integration. Technique matters: physicians may use cannulas or very fine needles to minimize bruising and protect vascular structures. Results hinge on accurate depth placement and careful tissue assessment.
Under-eye fillers address the primary hollowness but may require touch-ups as tissues remodel. Potential risks include swelling, bruising, transient redness, and, rarely, vascular occlusion when injections are misdirected. Layering fillers with fat grafts or fat repositioning can extend longevity in cases with deep hollows. Patients should avoid NSAIDs around the procedure and follow post-injection guidance.
Combination therapy with non-surgical approaches can enhance brightness without sacrificing natural look. In select cases, a light botulinum toxin treatment around the orbital area may reduce dynamic lines that accentuate hollowness. Newer injectable formulations optimize dispersion in thin skin, improving comfort and contour. A thorough consultation helps determine whether Juvederm, Restylane, or other fillers best fit the anatomy.
Lower eyelid rejuvenation
When hollowness is profound or the tear trough merges with loose eyelid skin, surgical intervention may be more durable. Lower eyelid rejuvenation commonly involves fat repositioning or grafting and careful removal of excess skin if needed. Blepharoplasty techniques have evolved in Korea to preserve eyelid function and maintain natural contour. The surgeon plans the approach based on orbital anatomy, skin quality, and patient goals.
Fat repositioning moves fat from the lower eyelid to the tear trough, creating volume without adding bulk. Fat grafting can fill deeper hollows when fat is insufficient, using the patient’s own tissue for longevity. Some patients require fat removal or tightening of the eyelid to reduce lid retraction and ensure a smooth lid-cheek slope. Laser resurfacing and skin tightening may complement surgery to improve texture and glow around the eye.
Recovery differs by technique but typically involves edema for several weeks and a gradual refinement of the contour. Patients follow postoperative care to minimize swelling and protect healing tissue from trauma and sun. Long-term results depend on lifestyle, sun protection, and adherence to follow-up care with the surgeon. Ultimately, lower eyelid rejuvenation can restore a refreshed look while preserving natural expression.