In our experience, the only effective way to address moderate or advanced eyelid hollowness is by grafting of structurally intact fat. Mild depressions are best left alone. Patients with severe hollowness may require more than one operation for optimal volume restoration. A realistic goal is a nice improvement that looks natural rather than complete elimination of an often multi-factorial problem.
Because orbital fat grafting is still new, such techniques are not widely available. Consequently, some Asian patients with natural or surgical hollowness are advised that no remedy exists.
Others may be offered treatment by injection of liposuctioned fat aspirate or temporary commercial fillers. Unfortunately, superficial injection yields little or no lasting help for deep hollowness, while injection into the deeper orbit is both dangerous and ineffective.
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