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A young lady is frustrated with the hollowness under her eyes, which she has tried to hide with makeup, but she feels it doesn’t really help. She is trying eye exercises to strengthen the muscles under her eyes. She also has a crease under her eyes, which she hopes doesn’t get worse.
New York Oculoplastic surgeon Amiya Prasad, MD reviews her photos in this video, and explains the cause of hollowness, and explains how this area can be addressed:
1:15 - Dr. Prasad’s background training and experience with under eye bags and treating hollowness under the eyes
1:49 - How people with under eye hollowness usually have the problem due to heredity (among young people) or age-related changes in the late 30s or older
2:23 - How people think they look hollow because of a valley next to their eye, which is also called the tear trough
2:49 - How appearance of the tear trough is affected by two factors: a volume deficit, and lacking skin quality evident in the dark circles under the eyes
3:26 - How hollowness and discoloration under the eyes can be treated with just an injectable treatment without surgery
3:41 - How puffiness under the eyes is a different situation, and needs a different procedure
3:48 - How this lady’s situation can be treated with a softer hyaluronic filler like Restylane, which can blend well with this area
4:18 - How the limitation of filler in this area is that it has to be maintained as they do eventually breakdown
4:29 - How Dr. Prasad found from experience that fillers under the eyes last longer than when used in other areas, with Restylane supposedly lasting 6 months, but Dr. Prasad has seen it last over a year
5:03 - How any procedure done around the eye always has possibilities of temporary swelling or bruising, so he does treat many patients on a Friday so worst case scenario, they have gone down by Monday
5:33 - How little aftercare is needed after filler placement, usually just gentle massage if even needed, but Dr. Prasad does see filler patients after two weeks to see if less or more material is needed
6:09 - How under eye dark circles are treated for skin quality, skin thickness, skin color, or crepiness, he uses platelet-rich plasma (PRP) to stimulate collagen and blood supply to improve skin quality
7:03 - How Dr. Prasad uses PRP to treat other areas of the body such as scar treatment, acne scars, and wrinkles
7:21 - How the need for PRP for this lady still requires a physical exam to see if it is appropriate
7:48 - How Dr. Prasad assesses with patients with similar issues if it is due to skin quality, volume loss, or a combination of both
8:00 - How Dr. Prasad advises meeting with eyelid specialists, and that filler treatment is a bit of commitment since it requires maintenance, but it also can be tried and dissolved with hyaluronidase if it’s not to her liking
8:34 - How eye exercises will not help her as the eye muscles underneath the eye don’t become thick, with the exception being people with neurologic issues that cause benign essential blepharospasm
8:54 - How the crease under her eye is an anatomic concern, and chasing these lines may not be worth the effort and expense in treating it, but PRP may help it a little, but hollowing can definitely be treated
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