I'm 19 and I have eye hollowness which makes me look tired all the time even if I’m not.

I have had it since I was baby so what's the best for it?

Thank you for your question!

You’re 19 years old and you submitted a photo and you’re asking what’s the best

solution for under eye hollowness. Well, certainly, I can address this question for you but I

would caution you at 19 to most likely delay any intervention but I think it’s important

that you understand how this issue is addressed at a practice such as mine.

To give you a little background, I’m a cosmetic oculofacial plastics surgeon specializing

in cosmetic and reconstructive procedures of the eyes and I’ve been practice for over

20 years in Manhattan and Long Island. So the issues with hollowing is as you described

in your situation, obviously is not age-related, you’re very young, but it does happen commonly

with aging. So to give you a sense of what we do and again, I’m cautioning you at a

young age to not necessarily pursue this because there is maintenance involved and maybe difficult

and particularly important for you to also understand is that your face is maybe still

maturing which means that a lot of things are still changing and it may be not as important

in a couple of years or as significant, I should say, as it is now.

But to address under eye hollowing, we’re talking typically the tear trough area and

the V deformity area under the eyes. Now these particular anatomic areas, when these are

particularly deep can certainly make the eyes look sunken and make the individual look very

tired. In our practice, we routinely treat this area with fillers such as Restylane and

Juvederm. These fall in the family of hyaluronic acid fillers. Now this is a very delicate

area and it does require a thorough knowledge of the anatomy and the precision to actually

make these corrections successfully and consistently.

In addition to that, we also use something called platelet-rich plasma (PRP). In patients

who have more of an age-related change, platelet-rich plasma works very well with hyaluronic acid.

In other words, what it does is it stimulates collagen, stimulates blood supply and we have

seen the aesthetics of the eyes improve greater than when we do hyaluronic acid alone and

it’s routine for us since we have so much experience with platelet-rich plasma or PRP

to actually do this in combination and get very nice results.

We also routinely follow our patients very closely. We want to see how they respond to

the hyaluronic acid. Sometimes people swell, sometimes people need reduction, may be they

need sometimes a little bit more. So there’s a lot of finesse to try to get the areas to

look right because it’s pretty unforgiving. People often come to us from experiences with

other doctors who do the injections and then essentially, don’t follow them that closely

and they’re lumpy and they’re regular and very often, we have to use hyaluronidase

to get rid of the hyaluronic acid. It’s an enzyme used to dissolve this.

So you can understand why I’m cautioning you, someone who is 19 years old, to start

pursuing this, may not be very practical but that’s at least an explanation of the anatomy

and how we help people in a situation similar to yours. So I think that it would be a good

idea for you to at least meet with your physician, your family physician and just discuss this

issue. There may be issues with hydration and skin care or meeting with a dermatologist.

Just think non-invasive and minimally involved at this time of your life where you don’t

want to commit to doing things that require maintenance. It’s usually not practical

for someone in your age range.

So I hope that was helpful, I wish you the best of luck and thank you for your question!