What causes Hollow Eyes?
The tear trough is the groove that runs from the inner corner of your eye down towards your cheek. When it’s well supported, the skin sits flush against the bone and you get a smooth transition from lower lid to cheek. When it isn’t, you get a visible dip, and that dip casts a shadow. It’s simple physics, not fatigue.
There are three things I look for at consultation, because the cause changes the treatment:
Genetics. Some people are simply built this way. Thin skin, a naturally deep bony orbit, or minimal fat padding under the eye can mean hollow eyes are visible from your twenties, sometimes even in childhood photos. I have patients in their late twenties who’ve had this look their entire lives and assumed nothing could be done. Quite a lot can be.
Volume loss with age. As we get older, we lose fat and bone from the face, and the eye socket itself actually enlarges. The fat pad that used to cushion the lower lid drops and thins, and the cheek beneath it loses support too. The result is a hollow that appears gradually, usually from the mid-thirties onwards, and gets more noticeable each year.
Pigmentation. The skin under the eye is thinner than almost anywhere else on the face, so blood vessels sitting close to the surface show through more easily, giving a bluish or brownish tinge. This is often layered on top of a structural hollow, which is why some tear troughs look dark as well as sunken.
Most of the patients I see have a combination of all three, which is exactly why a proper consultation matters more here than almost anywhere else on the face.
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