Did you know that the appearance of hollow and sunken eyes is influenced by the junction between the lower eyelid and the cheek? It may not seem like a typical “junction,” as the two areas blend together, but the smoother this junction is, the less hollow your eyes will appear. This particular area is called the tear trough crease.

As we age, some people experience hollow tear troughs, while others develop puffy eye bags or bulges of fat, caused by the descent of under-eye fat from its original position. When the tear trough area becomes hollow, the eyes can look sunken.

Why do eyes become more sunken with age? Two factors come into play— the loss of periorbital fat, which is the fat beneath the skin in the eye area, and bone resorption.

Around your early 40s, the fat pads in your face, including those under your eyes, start to shrink. These fat pads, known as “periorbital fat,” are among the first to diminish. With less fat, the sunken-eye effect becomes more noticeable, as the skin becomes looser, saggier, and more prone to folding.

In addition to fat loss, we also experience bone mass reduction in certain areas of the face as we age. The temple area, around the eye sockets, along the jaw and chin, and around the mouth, all undergo gradual collapse inwards. Surprisingly, the eye socket even becomes larger than it was in your younger years. This fact is not just an illusion, as it can be observed when comparing the skulls of younger and older individuals.

For individuals with darker skin and pigmentation in the under-eye hollows, the appearance of hollowness can be more pronounced due to how light interacts with the skin.

Understanding these factors can shed light on why the eyes may appear more sunken with age.

Hollow eyes are commonly attributed to ageing and genetics. When fat is lost, it diminishes from the entire body, including the face. Therefore, significant weight loss can exacerbate the appearance of hollowness in the eye area.

When it comes to naturally adjusting periorbital fat, chances are slim. Aging often forces us to choose between our face and body, and even if we prioritize our face, it’s unlikely that fat will distribute evenly, especially under the eyes. However, there are reliable options available that may require extreme measures. One option is to consider an eye lift, also known as a blepharoplasty, where the excess fat pads above or below the eyes are smoothed out and repositioned during the procedure.

For non-surgical alternatives, fat injections — as the name suggests — involve injecting your own fat into areas where volume has been lost, while dermal fillers can also provide a solution by replacing some of the volume around the eye socket. It’s important to note that filler injections are typically avoided closer to the eye due to the sensitive nature of the area. Not only is it a complex network of nerves and blood vessels, but also a space that extends towards the eye. Precise positioning is required to ensure the filler reaches the bone or sits just under the skin, rather than mistakenly entering the delicate eye area.

Navigating the realm of adjusting orbital fat offers a variety of options, but it’s crucial to consider the potential risks and consult with a qualified practitioner to achieve the desired outcome while prioritising safety.

In non-surgical terms, there are no permanent solutions for sunken eyes. However, a lower blepharoplasty (also known as a lower-eye lift) can provide a noticeable improvement. Alternatively, cautious treatment with injectable fillers can enhance the area for up to one year.

Skincare, unfortunately, cannot truly restore lost volume to a face that appears gaunt. While certain creams and makeup products claim to have a “plumping” effect, they only address the surface of the skin, resulting in a softer and less wrinkled appearance. However, it’s crucial to understand that this effect is minimal, measuring mere millimeters. Despite any misleading packaging claims, skincare products cannot replace lost volume beneath the skin’s surface.

As you age, you might try maintaining a higher body weight in the hopes that the fat in your face will stay beneath your eyes. However, it’s important to note that this approach may not always yield results. Unfortunately, you can’t control where the fat will accumulate.

When it comes to addressing the loss of volume around the eyes, it’s important to understand the underlying causes. While some might argue that facial exercises targeting the eye area can help, skepticism arises as this loss is primarily due to the reduction of fat rather than muscle. Furthermore, the aging process also involves the loss of bone in the tear trough.