HOLLOW EYE, SUNKEN UPPER EYELID : FILLING WITH HYALURONIC ACID INJECTIONS

What is a hollow eye ?

A hollow eye refers to a lack of volume in the upper eyelid area. It must be distinguished from round eyes, where the sclera (the white part of the eyeball) is more exposed due to eyelid retraction. A hollow eye can sometimes give the impression of a round eye, but these are two different conditions. A hollow eye makes the gaze appear aged and tired. A youthful eye is a full eye !

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Key Points

Treatment of hollow eyes in Geneva   

Hollow eyes are characterized by a loss of volume in the upper eyelid. This aesthetic concern is often associated with pronounced under-eye circles, a tired appearance, and thin skin around the eyes.

How to get rid of hollow eyes ? Hyaluronic acid injections offer an effective and safe solution to correct hollow eyes. The gaze becomes rejuvenated and radiant.

Until a few years ago, the only way to treat this concern was through surgery : upper eyelid lipofilling. Thanks to advances in the medical field, hollow eye correction can now be performed without heavy downtime, using hyaluronic acid injections directly into the upper eyelid. The procedure is performed in the office and takes about fifteen minutes.

photo causes hollow eye

Why does the eye become hollow ?

Eye hollowing is the result of volume loss in the fat and/or bone structures.

Several factors can cause upper eyelid hollowing.

  • Aging : over time, bone resorption occurs and the skin loses its elasticity, leading to tissue sagging.
  • Loss of collagen : decreased collagen and elastin production makes the skin thinner and more fragile.
  • Aggressive blepharoplasty : removal of too much fat during surgery can create an overly hollow upper eyelid.
  • Genetics : some individuals are naturally predisposed to having hollow eyes.
  • Lifestyle : stress, lack of sleep, and an unbalanced diet can worsen the issue.

How to get rid of sunken eyes ?

To reduce the appearance of sunken eyes, it is necessary to identify the underlying factors. This condition is often caused by volume loss, leading to a hollow and tired appearance.
To address this, the non-surgical option available in aesthetic medicine is the injection of hyaluronic acid.
Hyaluronic acid injections are particularly effective, as they restore lost volume and naturally fill the hollows.
This safe and precise procedure helps restructure the orbital area, reducing the appearance of sunken eyes. The face looks more rested and rejuvenated.

How to prevent or reduce hollow eyes ?

There is no definitive way to prevent the appearance of hollow eyes. However, skincare and lifestyle influence the hydration and brightness of the skin in this area.
Therefore, it is advisable to :

  • Maintain proper hydration, which is essential for skin health.
  • Follow a skincare routine : moisturizing creams and serums containing ingredients such as hyaluronic acid, vitamin C, and retinol help maintain skin elasticity.
  • Apply sunscreen daily to prevent premature skin aging.
  • Eat a balanced diet.
  • Ensure sufficient and quality sleep.
  • Maintain a healthy lifestyle.

How to fill hollow eyes ?

Filling the upper eyelid is done either through hyaluronic acid injection in aesthetic medicine, or upper eyelid lipofilling in aesthetic surgery.

Dr. Romano uses a non-hydrophilic hyaluronic acid such as Restylane, injected with a cannula along the upper orbital rim.
The number of syringes used varies between one and three. Beyond that, Dr. Romano recommends surgical lipofilling.
The filling must be done progressively to allow the product to settle properly.
Dr. Romano often injects only one syringe (for both eyes) per session. Sessions should be spaced two months apart. Given the technical difficulty, this injection is performed by only a few practitioners.

Photofilling of hollow eyes by injection of hyaluronic acid

Hyaluronic acid for hollow eye correction

The injection of hyaluronic acid to correct hollow eyes is a simple and quick procedure.
During the initial consultation, Dr. Romano analyzes the patient’s anatomy, discusses their expectations, and explains the possible outcome.

In fact, for very pronounced hollowness, the best – and sometimes only – solution is surgical intervention.
Significant skin laxity in the upper eyelid may become more evident after injection. In these cases, Dr. Romano will inform you and, in most cases, advise against the injection.

Hyaluronic acid is meticulously injected at the level of the upper orbital rim, against the bone and not into the upper eyelid, using a cannula. The cannula is a blunt-tipped needle. Injection into the upper eyelid causes permanent swelling, lump formation, and the Tyndall effect.

The procedure usually lasts about ten minutes and is minimally painful.
After the session, the patient is advised to avoid sun exposure and physical activity for the first 24 hours.

Safety of hyaluronic acid injections around the eyes

The safety of hyaluronic acid injections around the eyes is a primary concern for both patients and practitioners.
Although this is a minimally invasive procedure, it must be performed by an experienced and qualified doctor to ensure optimal and risk-free results.

In terms of results, a poorly performed injection can lead to :

  • Surface irregularities and a wave-like appearance.
  • Drooping or closing of the gaze due to overfilling.
  • Permanent swelling.
  • The Tyndall effect : the filler appears bluish or purple under the skin.
  • A sharp analytical ability when assessing the orbital area.


To ensure a safe injection, it is essential to consult a practitioner who possesses :

  • In-depth knowledge of the orbital anatomy.
  • Full technical mastery of the procedure.
  • A fairly sophisticated ability to analyse the orbital zone.
photo rejuvenate the eyes with an injection of hyaluronic acid

Eye rejuvenation with hyaluronic acid

Depending on the patient's needs and request, a comprehensive eye rejuvenation treatment is performed.

Results before/after hollow eye treatment

The result is not truly immediate. The eyelids are swollen at the end of the session. This swelling tends to increase to a varying degree in the days that follow.
The final result is obtained three weeks after the injection. The eyes appear refreshed and rejuvenated. The face looks brighter. Bruising is rare.
Touch-ups are done every two years, with only one syringe necessary, regardless of the quantity used during the initial injection.

Hyaluronic acid price for hollow eyes

Type of consultation Generally practiced rates
Hyaluronic acid for
CHF 900 per syringe

Hyaluronic acid injections for hollow eyes : patient reviews

Patients who have undergone hyaluronic acid injections to treat hollow eyes express overwhelmingly positive feedback.
Many report great satisfaction with the improvement in their gaze : the eyes look less tired and more youthful.

  • The non-invasive nature of the procedure.
  • Rapid results.
  • The short recovery time, allowing for a quick return to daily activities.
Are hyaluronic acid injections for hollow eyes painful?

Most patients feel little or no pain.

Patients are asked to avoid sun exposure, saunas and physical activity for 24 hours.

It is impossible to prevent age-related hollowing of the eyes. There are a number of things you can do to slow the ageing of the skin around your eyes. It is advisable to keep the skin around the eyes well hydrated by using specific moisturisers.
To combat premature skin ageing, it is advisable to protect the skin from the sun by wearing sunglasses and applying sunscreen.

Results can last between one and two years, depending on individual metabolism and the product used.

The only effective treatments are hyaluronic acid injections and lipofilling of the upper eyelid.

Hyaluronic acid injections effectively fill hollows. The results are temporary but long-lasting.

Other areas to be treated

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