Eyes Part 2: Hollowing, troughs and dark circles under the eyes.


I have genetic hollowing under my eyes and nasal frown line (genetic too) what filler is better for me?

The last post (see it here) was about good products and treatments for care of the eye area skin. Thinner than other areas on the face, the eye area has very little dermis, the layer of skin with all the collagen and elasticity. It’s even thinner than the skin on the neck. Both areas have very few to no oil glands, and are prone to dryness.

Key Considerations:

  1. Very thin and not much dermis, so not very elastic. Don’t stretch or rub it! Be gentle.
  2. Few to no oil glands. Use moisturizer at least twice a day. Even better if it’s an eye area cream with actives. See the last post!
  3. Very prone to sun damage. Wear your sun glasses, hats, and use an eye area sunscreen when outside for any length of time.

Hollowing & Troughs

Caused by our genes usually. Look at your parents eye area! Also, by the natural separation of the fat pads around the eyes from the cheek fat pads.

  • Creams, moisturizers and gels, basically any topical, will NOT solve this. We all wish they would but it’s dreaming!
  • Fillers (experts only please) can be done and help in this area. This can be dangerous and a lot of experience is necessary to be safe. Bumps are common and often need to be adjusted. In my opinion, Restylane is the best filler for this area. Juvederm is not great (too hydrophilic). Cannulas are generally safer than needles, but the expertise of the doctor is more important.  These fillers are FDA approved, but this is an off-label use.
  • Another option is plastic surgery with repositioning of the fat pads or fat grafting. This has another set of complications which your surgeon should explain, if you seek a consult.

Dark Circles

Caused by the above, or small dilated veins (purplish in color), or melanin pigment (brown). And, often dark circles are a combination of these or all three.

  • See above if it’s the hollowing
  • If it’s veins, eye creams that contain niacinamide, Vit K, or arnica may help a little. If they aren’t too close to the eye, IPL can sometimes be used to shrink the blood vessels.
  • For brown pigment (melanin), use an eye area sunscreen and a plant based lightener. More on new ideas for this in a week or two.   🙂

Hope this helps,  Dr. I