While due to a shortage of orbital fat, upper eyelid hollowness can be seen in a variety of settings ranging from heredity to aging to trauma to overdone surgery.
If orbital fat (F) is deficient and has little or no forward projection against the orbital septum (E), the course of the levator muscle complex (L) becomes clearly visualized whenever eye is opened. Minus any "padding," the top part of the upper eyelid seems to tuck immediately under the socket bone (I) into a deep hollow ("superior sulcus").
When due to inherited family traits, such fat shortage reflects the way the lid is naturally "put together." When mild, any associated hollowness is most often of little cosmetic concern.
When acquired later in life due to aging or surgery, however, many patients are quite bothered by the loss of their previous eyelid contour and may seek volume augmentation to help restore the former appearance.