When it comes to under-eye hollows, Scottsdale, AZ facial plastic surgeon Kelly V. Bomer, MD says most patients don’t understand that it’s a “detail of the aging process.”
“In the majority of people, the bulging fat has happened from the aging process of the orbital rim receding and lowering,” she explains, adding that the treatment for improving under-eye hollows is not a one-size-fits-all solution and depends mainly on the age of the skin and underlying genetically inherited anatomy.
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“In younger patients, often only filler is necessary, while older patients often need skin rejuvenation, skin removal with under-eye surgery and filling of the recessed orbital rim with hyaluronic acid filler. I have tried many fillers under the eye and for many years now have the best results with Restylane Lyft that is blended with a small amount of saline to get just the right consistency for sturdy support of the overlying skin. For natural-looking augmentation, the filler should be placed on the bone, not directly under the skin. By rebuilding the bone with filler where it has receded, the hollow is brought out to meet the under eye fat to obscure shadows and recreate a natural lower eyelid–cheek junction.”
If you aren’t quite ready for the surgical route, Dr. Bomer does point out that keeping the under-eye skin “healthy” is key in reducing the appearance of under-eye shadows.
“Home care with retinol, glycolic and alphahydroxy acids, along with skin treatments like light peels, microneedling, and IPL, will keep the skin youthful, as long as it has been sun-protected. When people have retained fluid in the area, eye creams that contain caffeine are helpful to reduce shadows. People that have flat skin without fluid retention benefit most from plumping eye creams. Extremely important is a beautiful concealer that reflects light to reduce shadows and dark vessels. My favorite is Youngblood Ultimate Concealer ($30) because of its moisture, color, reflectivity and it’s ability to not settle into creases.”