What we treat / Under-eye hollows
Under-Eye Hollows
The shadow under your eye is usually a hollow rather than a stain. The pad of cheek fat that used to sit against the lower lid drifts downward over the years and leaves a trough along the rim of the eye socket, and the shadow you see is that dip catching the light. Filling the hollow removes the shadow. Where the darkness is pigment in the skin instead, adding volume changes nothing, so the first job at the consultation is telling the two apart.
Why it happens
Under the eye the skin is about half a millimeter thick and it sits almost directly on bone. When the cheek fat that supported the lid edge slides down, the rim of the socket becomes visible as a curved dip running from the inner corner outward.
Light falls into that dip and reads as a shadow. It is why the same face looks fine in soft light and tired under an overhead one, and why concealer only half works. You are painting over a shape.
How Dr. Mauer treats it
The main treatment
Dermal Fillers
A small amount of a soft filler placed deep, against the bone, rebuilding the ledge the fat used to sit on. Dr. Mauer places it himself through a cannula. The amounts here are measured in fractions of a syringe.
Read about dermal fillersSometimes instead
Laser & Skin Resurfacing
Where the darkness is pigment rather than a hollow, resurfacing treats the color. Dr. Mauer will tell you at the consultation which of the two you have, and he will say so plainly if volume is the wrong answer for your under-eye.
Read about laser and skin treatmentsWhat to expect
- Appointment
- 30 to 45 minutes
- Discomfort
- Numbing cream first, then pressure more than pain
- Downtime
- Bruising is common in this area and can last several days
- Visible
- Immediately, settling over 2 to 4 weeks
- Lasts
- 9 to 18 months for most people
Results for this concern
Individual results vary. Photographs are published only with each patient’s written consent.
Questions about under-eye hollows
Why is this area treated differently from the rest of the face?+
Because there is so little between skin and bone. A product that behaves well in a cheek can hold water under an eye and read as puffiness. The product, the depth and the amount are all different here.
Will it look puffy?+
That is the risk of putting too much in, and it is why Dr. Mauer treats this area conservatively and reviews you two weeks later. Adding a little more at the review is straightforward. Taking it away is a bigger conversation.
Can it be reversed?+
Hyaluronic acid fillers can be dissolved with an enzyme, and that is one of the reasons he uses them here.
I have had filler under my eyes before and it settled badly. Can that be sorted out?+
Often, yes. It usually starts with dissolving what is there, waiting for the area to settle, then reassessing from a clean base. Bring any record you have of what was used.
