Hollow Eyes (Tear Trough Hollowing)

What are hollow eyes?

Hollow eyes refer to a reduction in fullness around the lower eyelids and upper cheeks, often creating a hollow or shadowed appearance beneath the eyes. This can be present from childhood amd is part of an individuals genetic makeup . Changes may also develop gradually over time or may reflect an individual’s natural facial anatomy.

What causes hollow eyes?

Hollow eyes usually develop as a result of several factors working together, including:

• Individual facial anatomy and genetics.
• Some ethnicities have differing bone structure around the eyelid and cheek and eyeball positioning.
• Genetic zygoma (cheek bone) and maxillary (mid-face) bone underdevelopment.
• Gradual changes in the fat and supporting tissues with age.
• Changes in the underlying bone structure over time.
• Weight loss in some people.
• Skin quality and elasticity.

The underlying cause varies from person to person, makingan individual assessment an important part of the consultation.

Assessment

During your consultation, we’ll assess your lower eyelids, cheeks, skin quality and facial anatomy as a whole. We’ll also assess the relationship between the eyes, mid-face and surrounding structures, as several factors can contribute to the appearance of this area. Understanding the underlying cause helps determine whether management is appropriate for you.

Why assessment is important

Not all hollow eyes have the same cause. In some people, the appearance is primarily related to facial anatomy, while in others age-related changes in the surrounding tissues contribute. Hollowing may also occur alongside dark circles, under-eye bags or changes in the cheeks, and these concerns often require different approaches. Without a comprehensive assessment, management may not address the underlying cause of the concern or achieve an outcome that meets your expectations. A careful assessment helps guide appropriate, individualised management.

Individualised management

During your consultation, we’ll discuss whether management is appropriate for your individual concerns. If so, we’ll explain the available options, together with the expected benefits, limitations and potential risks, so you can make an informed decision about your care.

Prepared by
Dr Simone Doreian
Specialist General Practitioner
AHPRA Registration: MED0001163462