How Cosmetic Fillers can Treat Under Eye Hollowing in Young People, but will Require Maintenance

How Cosmetic Fillers can Treat Under Eye Hollowing in Young People, but will Require Maintenance

Thank you for the question. You are asking if Juvederm would be useful
for filling in the hollows and you describe a situation in your question with the photo
you submitted that you are 20-years-old and you feel that these are genetic or hereditary
hollows and the skin has gone a little bit crinkled and that you are having trouble covering
this up with makeup. And you feel like at the age of 20, you look
at least like you are 25. Well, I can certainly give you some ideas
based on how I approach patients like yourself in my practice and make a decision based on
some of this concepts once you understand this framework and how someone like me evaluate
people like yourself in practice. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve practicing in Manhattan and Long Island
for over 20 years and helping people with rejuvenating their eyes and making their eyes
look very good using a wide array of modalities from minimally invasive such as skin products
to procedures such as laser and as well as surgery something we do in our practice every
day.. So it is very important, before you chose
a particular product or solution, to define the problem that you are concerned about and
understand what the potential options entail. To begin with, I would say that when someone
who is young like yourself and who is 20 comes to our office, I always have to frame everything
in terms of whether or not it is worth the time and investment for someone who is younger
to do procedures that can help genetic issues that require some maintenance. So let’s begin with first the hereditary
aspect of the relative hollowing. You look at the tear trough area and the area
does look a little bit hollow and the area of the eyelid to cheek area can also look
a little bit hollow and there are may be some natural genetic hereditary pigmentation and
some lines. You didn’t mention in your question whether
or not there is a history of smoking, whether any issues of allergies and sinus problems
and these are the kind of things we first learn about before we make recommendations
in our practice. Coming up with the concept about what is the
anatomy. So technically there is a relative deficit
of volume, let’s say in the tear trough and the eyelid to cheek junction. Generally for this area, we use a filler like
Juvederm but I prefer to use Restylane. Restylane is a little bit softer. I find, in my hands, it works better and it
can make an improvement. I often combine Restylane with platelet-rich
plasma (PRP). Platelet-rich plasma (PRP) is derived from
your own blood and contains growth factors and elements of the blood that are required
for wound healing. So what we have been able to do is successfully
improve skin quality and get some long term benefit from its combination with a hyaluronic
acid filler. Now that being said I would caution you that
you have to be prepared with these types of procedures. When you do something like this, you have
to continuously do it if you want to maintain a certain look. Now for some young people especially in our
area, New York City, we have a lot of actors, we have a lot of people who are in front of
cameras and they will make the time and investment but I think that it is a different scenario
when a person who is 20 and comes with this issue to someone who is 40. Why? Because for a 40-year-old, it is a change. It is a shift of volume loss and other things
and we deal a lot of these aging changes. But when it comes to someone younger, I just
want you to be sure that you are willing to do this long-term. Now, with that being said, what is nice about
these modalities is that they are not permanent. You can try it and you can see if you like. You see if it is worthwhile for you and decide
to make this part of your approach to helping yourself look better. But again, I would be cautious about someone
who is very young like yourself engaging this type of correction because the time and often
the resources can be somewhat challenging. In addition, you have to understand whenever
you have a procedure, even if it is done with minimal trauma, with blunt cannulas which
is technique of using cannulas that minimize bruising to minimize the tear trough and to
do these things, there is going to be some swelling. There is still a potential for bruising and
you have to factor that into your life. So from the perspective of skincare, you might
have some options where you want to try first the skincare options of topical creams. And in our practice, we have our own skincare
line and we help people customize what might be a good solution but basically the epidermal
to the superficial or the popular dermal levels of the skin but we can still create benefits
such as improving skin quality and skin color or discolorations, irregularities with topicals
but it takes a little bit of time as opposed to doing something with like a laser. So learn more about your options. Don’t just jump in and do something. And learn about this and again of course there
is still an option of not pursuing it beyond the initial experience because the material
is temporary whether it is Juvederm or Restylane or any injectable filler. And if you don’t feel like doing this at
this point in your life, you can wait till much later. So I hope that was helpful, I wish you the
best of luck and thank you for your question!


  • Candice Michelle says:

    Hi Doc
    I just wanted to you know that im a big fan of yours and hopefully very soon we'll meet…
    But before that can you please answer my question ?
    I've had a candle wax burn under my left eye when i was a kid the mark faded slightly throughout the years…im 21 and the mark just looks like a dark circle but permanent…its not a scar its just that it looks like i have a dark circle on one eye and the other is okay….im so depressed…ive tried bleaching it but didn't work only made it dry and irritated and gave me fine lines what treatments would you prefer for burns undereye ?
    Looking forward to your advice

  • Purie Zeondy says:

    I love this. A doctor that takes their oath seriously rather than just trying to weasel out as much money from patients as they can. I really appreciate your candor and insightful explanation and recommendations.

  • sara queen says:

    Hello Dr. Prasad,
    I would like to know if any of the fillers, either for face or eyes, are made of animal products? I heard there are rat molecules. Any pig products?

  • meur urme says:

    Hi Dr., I am a black female who has dark skin discoloration (not indentions, the actual skin is darker) on the inner sides of my eyes where my nose is. Sort of like where eyeglasses pads are placed and the size of the pads. I have had this for years and peels, bleaching cream nothing has seemed to work to lighten this area (curve of eye/nose area) would injections in this area help or what laser would I need. Thanks

  • Lilli Lil says:

    Are there any precautions and side effects for those of a very young age??? Does it quicken aging for those who are young and get the procedure done??

  • Stacy Samms says:

    I have a deep furrow line between my eyrbows I would like to have fixed.Β  I am 47. how much would this procedure cost?Β  lm looking for a non-surgical treatment.

  • catmo59 says:

    hi. I am48. my lower face is aging faster than the upper portion of my face. neck jowls laugh lines. what do you recommend. people still think I'm in my late cos but I don't like the lower face issues. what are my options?

  • zoe Daflower says:

    im 33 and with dry, dull hyper pigmentation skin. a few lines around the mouth and under the eyes are appearing with dark circle. what cream would you recommend?

  • champagne5552000 says:

    I've done 3 (Med Spa) consults for my hollow tear
    trough ' s. Never met with a surgeon..only injectors. They advised against any/all fillers. Why? Because it's such a sensitive area. Concealors/color correctors don't work. They all recommended a fat transfer. Any suggestions? thanks

  • Iman Hameed says:

    i am 16 years old and am having problems woth dark circles since my childhood. do you recommend eye fillers ?

  • Celia Vergara says:

    I will definitely go see you! I feel like you delivered a perfect explanation and I must see you!

  • Care Bear says:

    Hello i'm 22 i have the hollowness not as bad as the picture but i hate it because when i don't wear glasses i look weird and id like a solution since i'm getting married and i don't want to wear my glasses anyone have tips? comments?


    This was great!!! Do you recommend the semi-permanent fillers, that last up to 10 years or fat grafting?

  • ConnieAmarilla says:

    This video was Awesome! Very informative and gave me options instead of focusing on one solution. Thank you!

  • Makeup Time With Kelly says:

    What do you suggest for someone with severe dark circles and had them since childhood. Also longtime smoker and severe allergies as well.

  • L L says:

    Would you recommend this for someone suffering from dry and dark undereyes? I suffered with eczema in the undereye area and due to treatment there are a lot of fine lines and they are very hollowed out. My under eyes are very creased so I can't hide it with makeup.

  • Sashua Harrison says:

    I have terrible eyebags and hallow. How long will the restalane last

  • Zahraa A.n. says:

    hi doctor
    i'm 23 years old and i have eye bags that make me look a lot older than my actuall age
    i really hate it.
    what do you suggest me to do?thanx.

  • MyinHAIRitance says:

    Thanks Dr. Prasad. You prefer restylane over vobella? Is vobella still good for eye tear troughs?

  • Beauty By Bridget D says:

    Thank you for being honest with this potential patient. It's refreshing to see a Doctor take his patients age, health, etc…into consideration over just gaining from it monetarily:).


    Hello doctor i am from India..
    I sleep for 8-10 hours
    I go to gym
    I follow perfect diet
    I drink sufficient water to stay hydrated
    I followed all the so called home remedies but nothing seems to work..
    I have deep hollow eyes I feel like my eyes are going in day by day and I am facing this problem from 6 years…
    Please help me πŸ™

  • Babymamaz says:

    Can you come over to prov ri please lol

  • Catherine Trancess says:

    Hello Doctor.I am 29 years old. I am an indian-South African female who suffers from allergic rhinitis and eczema. This has caused me to constantly rub my eyes. My under eyes are very dark and very hollow. The indentation is very visible and it makes me look old. What do you recommend? Thanks in advance.

  • Tanu Sharma says:

    I am 20 years old.. I also have hollowed eyes and dark circles around my eyes…from when I was 14 years….. I don't know may be it is genetic because my mother too have these… But I have more than her… πŸ˜‚πŸ˜‚
    Sir please suggest me something to get rid of them.. πŸ™πŸ™

  • Ashwini Yedaboina says:

    Hello Doctor!
    Will you be visiting Hyderabad anytime?
    If yes
    Please let me know
    I would like to get my Mom under eye treatment done

  • virendra vk says:

    Sir i want fat graffting under my eyes because my under eyes is hollow and have a dark circle ..i want cure this ..All my freinds call me old man i am only 20 years old but look like 50 is genetic sir i want cure this from fat graffting is safe or not plz tell me sir…thank you sir

  • shiwani kumari says:

    I have dark circkes and also two lines under my eyes which may beinherited from my mother or i dont drink water properly since from my childhood nd also i m a medical student nd 19 yrs old nd i have 2 do late night studies.can u pls tell me what should i do to reduce it

  • Dawn Young says:

    I am 47 and looking into the under eye hollowing treatment, restalyne is still my first choice. I work in Sephora, so I am consistently wearing a lot of makeup daily. I also am up close with clients during their makeovers. I appreciate your honesty in the way you answered her question. Not many dr’s are.

  • nadia faith says:

    Hello Dr. Thank you so much for this video I am 26 yrs old and I've always had dark & puffy eye circles since I was younger so I am sure they are hederetary. I've been wanting to get a tear through but now that I saw your video, it got me thinking of what other options I have before making a decision, what are some best other alternatives that you recommend? I've tried basic creams but is there a clinical cream that will work better?

  • Jake L says:

    Amiya Prasad, M.D.Β 
    I also have this kind of problem sir, I just turned 19 but my colleagues always teased me of being having these large under eye circles that I look like on my mid 20s. And you've mentioned to be cautious for the commitment since I'm on my younger stage. I just don't know what to do. It's my biggest insecurities that I bear for my entire teen age life. Pls help me. Thank you in advance

  • luisa gonzalez says:

    How often is the maintenance ?

  • Kesha Jones says:

    How long does the fillers last

  • akriti gupta says:

    I am from india I want the filler badly but i am afraid that it might cause blindness as i have read if accidentally injected into artery will cause immediate blindness. As there is no way to know where artery is, can it be the case

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