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Hollow Eyes

Written by: Alice Hart-Davis

Last Updated: 22 March 2024

What are hollow eyes?

Hollow eyes, also known as sunken eyes, are when the under-eye skin appears dark and sunken, the socket appears large, and the eyes appear to be set deep in the socket. Some people just have hollow eyes, and have them from a young age—there’s a significant genetic component to this—but they’re also something that can develop and get worse with age. Scroll down for answers to all the FAQs about hollow eyes.

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FAQ ABOUT Hollow Eyes


Why do my eyes look sunken?

This is partly to do with the junction between the lower eyelid and the cheek. You wouldn’t think of it as a ‘junction’ as such because one area blends into the other—but the smoother that junction is, the less hollow your eyes will look. This junction is also known as the tear trough crease. Some people’s tear troughs become hollow as they age, others have puffy eye bags or pouchy bulges of fat, where the under-eye fat has slipped and descended from its original position. It is when this tear trough area becomes hollow that eyes can start to look sunken.

Eyes become more sunken with age because of two factors: the loss of periorbital fat—that’s the fat that lies beneath the skin in the eye area—and bone resorption.

  1. As you get older—usually starting in your early 40s—the fat pads in your face begin to shrink. You have around 20 of these fat pads in your face, some of them being under the eyes. These fat pads are known as ‘periorbital fat’ and are among the first to go. When this happens, the sunken-eye effect is made even more noticeable because the skin, no longer stretched over the same volume of fat, is looser and saggier and more likely to fold.
  2. We lose bone mass from the skull as we age, from the temples, around the eye sockets, along the jaw and chin, and around the mouth—in short, everything in the face begins to gradually collapse inwards. This means that the eye socket actually becomes larger with age than it was when you were younger. We can see this when looking at the skulls of younger and older women (a bit gruesome, I know), so it’s not just an optical illusion; your eye area actually does become more hollow than it used to be.

If you have darker skin, and pigmentation in the hollows under the eyes, this can make the hollowness look even more severe because of how the light plays on the skin.

Does weight loss cause hollow eyes?

Generally, ageing and genetics are more likely to be the causes of hollow eyes. That said, when you lose fat, you lose fat globally—i.e. from everywhere, from your face as well as your body—so significant weight loss can make the appearance of hollowness that bit worse.

How do you increase periorbital fat?

There is no way of doing this naturally. If you were to follow the old maxim of having to choose between the face and the body as you age, and chose to have the face carry more weight, you might be lucky and keep fat in the right parts of the face, ie underneath the eyes. But frankly, it’s unlikely.

The reliable—but extreme—way to adjust periorbital fat is to have an eye lift, a blepharoplasty, and have the fat pads above or below the eyes smoothed out and re-draped as part of the procedure.

When it comes to non-surgical options, you can go for fat injections—which, exactly as they sound, are injections of your own fat into areas where volume has been lost. Or, you could opt for injections of dermal filler, as below. This won’t increase the amount of fat in the area, but it will replace some of the volume around the eye socket.

It’s possible to have filler injected around the orbital rim, but practitioners will avoid injecting fillers any closer to the eye than that. This is partly because this area is a snake pit of nerves and blood vessels which you absolutely do not want to hit with a needle (if filler is injected into a vessel leading towards the eye, it could block it and cause blindness), and partly because this area is a space going back towards the eye. It’s possible to position filler down onto bone or just under the skin, but not into a space such as the one around your eyes.

Can I use filler under my eyes?

Yes, you absolutely can—and it can have great results. You can use filler up to the orbital rim, but not beneath the skin of the lower eyelid. What you can use in that area is PRP (platelet-rich plasma, extracted from your own blood), which stimulates regrowth of skin tissues and strengthens the area.

Some fillers are designed to be used close to the eye—these have a lighter, more fluid texture than, for instance, the fillers used for adding structure around the jaw, as the molecules of hyaluronic acid within them are less heavily cross-linked and bound together. Have a look at our page on fillers for more information on what the procedure involves and what the different types of fillers are. I’d also recommend watching the following episode of Tweak of the Week, where I specifically look at under-eye filler.

It’s worth noting that if you have dark circles from hyperpigmentation, having filler injected into this area will not reduce the pigmentation—that needs to be treated with skincare. In fact, there are a lot of complicating factors—every face is different, and every face will respond best to different avenues of treatment, so the most important thing is to find an experienced practitioner whose work you like the finished look of, as they will be best placed to figure out what the best course of action is for you as an individual. You don’t want to end up with a botched job where you have ‘speed-bumps’ of filler beneath the eye, so your practitioner really needs to know their stuff.

How can I permanently fix sunken eyes?

Unfortunately, if we’re speaking in non-surgical terms, nothing can be done to permanently fix the appearance of sunken eyes. Surgically speaking, though, a lower blepharoplasty (also known as a lower-eye lift) can improve the look of the area. Cautious treatment with injectable fillers should improve the area for a year at a time.

Can I use skincare to treat sunken eyes?

No. skincare cannot help to revolumise a face that’s starting to look gaunt. Some creams or makeup promise a ‘plumping’ effect, but what they’re referring to is plumping up the skin. This will indeed make the skin look softer and less wrinkly, but this will only make a difference of a fraction of a millimetre. Skincare cannot and will not do anything to replace the volume that has been lost beneath the surface, whatever its packaging might suggest.

Can I prevent sunken eyes?

Other than maintaining a higher body weight than you might be used to as you age, in the hope that the fat in your face will stay put beneath the eyes, which it may not do—no, you can’t. Sorry.

What are the best tear trough exercises?

I’m sceptical as to how well these work because the loss of volume around the eyes is mostly due to loss of fat in the area, rather than muscle. There are people who do suggest that facial exercises for the eyes might work, but I’m not convinced. Once you factor in the way we lose bone in the tear trough as we age, it’s hard to imagine how any exercise can claim to improve volume in the eye area.


ASK ALICE

Alice answers your question. Want to ask Alice a question? Pop it in here and check back in a few days for the answer.


I'm starting to see hollowing under the eyes in my five year-old. I know it's genetic because one parent has the same thing. Is there a way to treat this in kids or prevent it early on?

Hi, you're absolutely right that it's genetic and no, there's nothing you can do to prevent it and some of us just do have that hollowing handed out by nature. A touch of sunscreen to keep the skin in best health is all you want to use, and do what you can not to fret over the issue or draw attention to it, so you don't make your lovely child self-conscious about something that is entirely natural and just the way their face is made.

Best treatment for under eye dentation heading on edge of cheek bone and fine lines?

Hiya, TTG editor Georgia here. I'm not sure exactly what you mean by 'dentation' under the eyes. If you're talking about a kind of hollowing then you may be a candidate for tear-trough filler, but this is a very intricate filler placement that certainly isn't suitable for everyone, so use our Practitioner Finder to find someone experienced in treating the eye area and book in for a consultation. And wrinkle-relaxing injections will soften those fine lines at the corners of your eyes....

Can you advise on experienced doctors for tear trough treatment please?

There are many doctors listed on the Practitioner Finder here who offer tear trough treatment.

I have a swollen lymph channel on one eye after having my tear troughs filled ten years ago. It started to appear a year after and now looks worse than ever after the filler had disappeared... will hyaluronidase sort this out?

Hi, yes it might well sort it out – find a practitioner who offers hyaluronidase dissolving that is guided by ultrasound – so that they can see precisely where the filler is sitting, which is affecting your lymph channels.

Have you tried Nucloefil for under eyes as an alternative to filler? I would like to find a reputable doctor.

Hiya, TTG editor Georgia here. Neither Alice nor I have tried Nucleofill but polynucleotides sound very interesting. Dr Sophie Shotter and Dr Maryam Zamani are two London-based practitioners who are offering it, and if doctors of their calibre are working with the product then I'd be inclined to say it's good. It's not really an 'alternative' to dermal filler because it's a completely different category of injectable (more of an injectable moisturiser), but I hear it's a good option for under-eye crepiness, wrinkles, and hollows. Go for it....

Hello, I am 48 and really starting to look old, especially when I look at photos. What do you recommend as the most effective way to look fresher and better without toxin or filler? Is it HIFU or profound or another treatment? Or would I really need...

Hiya, TTG editor Georgia here. Dr Strawford will be best placed to answer all these questions for you once he's assessed your face and talked to you about your exact concerns. He is an expert practitioner with a great deal of experience. The tweakments you mention – HIFU, Profound (RF microneedling), toxin, and filler – all do different things that work towards making you look fresher and younger, but not in the same ways. Toxin for example won’t do anything about sagging skin but HIFU will, Profound will stimulate collagen production to tighten and plump the skin, but won’t replace lost volume in the ways filler will. So it all...

I'm searching for a new practitioner for tear trough filler after pregnancy. I had an OK experience before, however a few things put me off going back to the same person. While researching, other practitioners have suggested Juvederm Volbella. But...

I know what you mean about googling, it's enough to put you off anything. Tear troughs are tricky to treat and not everyone is a good candidate for filler in this area (if your eyes tend to go puffy and baggy and hold fluid anyway, the last thing you want is hyaluronic acid gel, which holds more fluid, in the area). Re brands/ products, it's more about the practitioner than the product. I.e. a good practitioner will know a) whether you're suitable for tear trough injections and b) what to use to get the result you're looking for....

I wanted to ask you if you have ever had tear trough filler and what was your experience? My dark circles/ hollows are of real concern to me and I'm considering this procedure with Dr Sophie Shotter who does my toxins. Your list of things that could...

Hi, I'm so sorry to have scared you with the list of things that can go wrong with/ after tear trough filler but I feel it's really important that people should be informed and aware of all the potential issues around any tweakment before they go ahead and book in for it. You would be told all these things at consultation stage and/or will find them all listed on the consent form that you will be asked to sign before going ahead with any treatment. Tear troughs are tricky. Some people are great candidates for tear-trough treatment but others aren't, so it's important to pick a practitioner who knows how to treat appropriately. The...

Who would you recommend in London for conservative fillers around the eye area? I’m thinking tear trough but also the outer area.

Have a look on our practitioner finder – you can search by tweakment as well as by area. There are loads of great practitioners on there who do really good tear trough work, and they will advise you whether this is an appropriate treatment for you.

Do you have a post or any advice on treating under eye hollows? I am terrified of looking fake, weird or done but on discovering this treatment is available i am very interested. Could you point me in the right direction?

Yes I do. I totally understand why you're cautious about having filler in your tear-trough area to treat under-eye hollows, but if it is well done, this is a brilliant treatment to disguise the appearance of those hollows. Take a look at this video where Dr Saleena Zimri is demonstrating a tear trough procedure And take a look at this page which is all about hollow eyes and what you can try - scroll down the page to see all the FAQs

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