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Melissa Hu, MD

Board Certified Facial Plastic Surgeon

It's natural to take steps to look your best
  • Dr. Melissa Hu

Lower Eyelid Rejuvenation

Do you feel like your eyes look tired all the time even though you had restful sleep? Does it seem like the puffy bags, deep troughs around your lower eyelids never go away? Tired of looking tired? Here are some of your treatment options...


If the skin around the lower eyelids are only slightly crepey with no excessive redundancy, you may want to start with some skin care options. Medical grade eye creams can moisturize and support the collagen, as a result, slightly tightening the skin around the eyes. Some eye creams target the dark circles around the eyes which is typically due to vascular congestion around the eyes.



Microneedling involves the introduction of small microinjuries to the skin to stimulate the wound healing process and collagen production which may lead to skin tightening.

Radiofrequency and ultrasound procedures function in a similar fashion by disrupting the collagen by using energy waves from the surface of the skin. The disruption of the collagen stimulates wound healing which then leads to the production and reorganization of collagen to tighten the skin.



Dermal fillers such as Juvederm and Restylane can be used to fill the trough or hallowing in the lower eyelids. Filling this area helps smooth the transition between the eye and cheek compartments. It is recommended to underfill this region, as excessive filler can take on a bluish hue and appear quite unnatural. Overfilling the area can also have an unnaturally plump area of the lower eyelid.



When the lower eyelid has excessive skin, significant fat pockets, and deep hallowing, surgery may be your best option. It should be noted that surgical techniques differ based on the cause of lower eyelid changes.

  • Excessive skin is excised and will require an external incision.

  • If the issue is excessive fat and fullness, the fat may be excised through an incision on the inner aspect of eyelid.

  • If hallowing is the problem, this is often due to the thinning of tissues and relaxation of ligaments over time. This results in the separation of tissue compartments around the eye and the cheek. The separation creates a valley or hallowing of the lower eyelid. Adequate treatment often requires a combination of techniques. This may involve the release and repositioning of fat as well as resuspension of midface tissues. The combination of these techniques should provide a smooth and rejuvenated appearance of the lower eyelid region.

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