Hollow Under Eyes Treatment: What Causes Tear Troughs and What Helps
Under Eyes Treatment: What Causes Tear Troughs and What HelpsHollow
The right hollow under eyes treatment depends on why the hollow is there. Shadows from tiredness improve with rest, a mild tear trough may be filled with filler or fat, and a hollow that sits just below puffy under-eye bags often responds well to lower eyelid surgery that moves that fat into the groove.
By Assoc. Prof. Dr. Preamjit Saonanon, oculoplastic ophthalmologist
What causes tear troughs?
The tear trough is the groove that runs from the inner corner of the eye down towards the cheek. It becomes deeper for several reasons, often together:
Anatomy and genetics. The shape of the eye socket and cheekbone can make the groove visible even in your twenties.
A tethering ligament. A band of tissue holds the skin down along the groove, so the areas around it bulge while the groove stays put.
Age-related volume loss. Fat and collagen in the cheek and lower eyelid decrease and descend over time.
Under-eye bags. Fat bulging above the groove makes the hollow below look deeper by contrast.
Thin skin and pigment. Thin skin lets the blood vessels and muscle underneath show through, adding a dark shadow.
Weight loss. Losing facial fat can reveal a groove that was always there.
Hollow under eyes treatment: what are the options?
Sleep, sun protection and skincare
Good sleep, sunscreen around the eyes and treating allergies can reduce dark shadows. They do not add volume, so a true groove will remain.
Filler or fat injections
Hyaluronic acid filler can fill a mild to moderate groove with little downtime, and the effect is temporary. The skin here is thin, so lumps or a bluish tint can occur, and blocking a blood vessel is a rare but serious risk. Read are under eye fillers safe before deciding. Your own fat can also be injected, but how much of it survives varies.
Lower eyelid surgery with fat repositioning
When there is both a bulge and a hollow, the bulging fat can be moved into the groove instead of being removed, through an incision inside the eyelid or just below the lashes. This treats both problems in one operation. Bruising and swelling usually settle over about 7–14 days. Like any surgery, it carries risks, and results vary from person to person. See our lower blepharoplasty page for details.
Is it a tear trough or sunken eyes?
A tear trough is a groove below the eye. Sunken eyes describe a deeper look to the whole eye area, often including the upper eyelid. The causes and treatments overlap but are not the same; read more about sunken eyes.
When should you see an eye doctor?
See an eye doctor promptly if one eye looks sunken or sinks back over weeks or months, if the change follows a facial injury, or if you have double vision or numbness of the cheek. Pain, pale or blotchy skin, or any change in vision soon after a filler injection is an emergency and needs immediate care.
Frequently asked questions
What causes tear troughs?
Tear troughs come from a mix of anatomy, a ligament that tethers the skin, age-related volume loss, under-eye bags above the groove, and thin skin.
Is filler or surgery better for hollow under eyes?
Filler suits a mild to moderate groove without bags. Surgery with fat repositioning suits a groove that sits below bulging under-eye fat. An examination shows which fits you.
Can hollow under eyes be fixed naturally?
Sleep, sun protection and allergy care can reduce shadows, but they cannot fill a groove that comes from the structure of the face.
Book a consultation with Assoc. Prof. Dr. Preamjit Saonanon in Thong Lo, Bangkok
LINE: @saonanon
Phone: +66 90 946 3090
Opening hours: Thursday 16:00–20:00, Saturday 09:00–20:00
This article is general information and does not replace a medical examination. Results vary from person to person.
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