Wayne, NJ facial plastic surgeon Jeffrey B. Wise, MD is not a fan of the “magic potions” you see on T.V.—especially when it comes to under-eye hollows.
“There are no miracle topical solutions for under-eye hollows. Be cautious.”
New York facial plastic surgeon Konstantin Vasyukevich, MD also subscribes to the school of thought that topical treatments aren’t the way to improve this common problem.
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“There are some tightening creams that can temporarily reduce their appearance. However, their effect lasts only for a couple of hours and the use of these creams is not a sustainable solution to the deep under-eye grooves.”
What’s more, Dr. Vasyukevich says, by the time patients with under-eye hollow come into the office they are usually already concerned with their eyes looking tired, and have gone through the gamut to see what will fix it.
“They notice deep shadows under the eyes and realize that these shadows cannot be easily covered with makeup. By the time I see them, most patients have already tried a number of under-eye creams with no improvement. The majority of my patients know that deep grooves and lines around the face could be improved with fillers and Botox; however, most of the time they are not sure of the specific treatment that could improve and rejuvenate the area under the eyes.”
One treatment he does believe can fix it: fillers.
“Right now, we prefer a hyaluronic acid filler called Belotero,” he says, adding that he considers the non-invasive treatment a relatively simple and effective way to improve the appearance of the under-eye hollow. “Most patients who are getting the treatment for the first time are especially pleased with the fact that this filler is dissolvable. This makes it possible to perform additional adjustments and small tweaks after the initial injection.”
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Dr. Wise also thinks that fillers in the right candidate can dramatically enhance under eye–aging changes—most notably in the tear trough, best described as a depression or hollow underneath the lower eyelid complex.
“We prefer fillers that don’t attract water because those fillers tend to lead to poorer outcomes. Most commonly, we use the fillers Belotero and/or Restylane.”
Of course, the fix isn’t always a one-move miracle. “Frequently, patients are treated with a multimodal approach such as fillers and a tightening device like a laser,” Dr. Wise says. “Just as commonly as we see tear trough hollows, we see under-eye bags that cannot be treated with filler. The gold standard correction for under eye bags is lower eyelid surgery or blepharoplasty, which produces dramatic results that last for several decades. Significant lower eyelid bags are poorly treated with fillers.”
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