Plastic surgery for under-eye hollows: what to know

A tear trough is the groove between the lower eyelid and upper cheek. Shadowing can come from bone structure, thin skin, changes in fat compartments, skin laxity or reduced mid-face volume. Dark circles may add colour contrast without being caused by a hollow, so a procedure that adds volume may not correct every concern.

A clinician examines the lower eyelid, cheek support, skin texture, puffiness, facial movement and symmetry. Eyelid surgery can reposition or remove selected fat and tighten tissue in suitable cases. Fat transfer uses processed fat from another area; under-eye filler is a less invasive alternative for selected anatomy, but it has its own risks.

Bring a list of medicines and previous injectables or operations. Discuss allergies, dry eyes, thyroid or eye disease, bleeding problems and expectations for shadowing, hollowness and skin quality separately. Ask about the anaesthetic, recovery, follow-up and whether a staged approach is sensible. Do not choose treatment from photographs alone; the lower eyelid is a delicate area.

After treatment, seek prompt medical advice for worsening pain, marked swelling on one side, fever, discharge, new double vision or difficulty closing the eye. Sudden vision change, severe eye pain, weakness or confusion needs emergency assessment. New or rapidly changing swelling should be examined rather than assumed to be a cosmetic hollow.

Is the main issue hollowing, puffiness, pigmentation or facial volume loss? Which option suits my eyelid and cheek anatomy? How would you manage asymmetry or an unsatisfactory result? What eye symptoms require urgent contact?