What Are Hollow Eyes? Causes Of Sunken Upper Eyelids And How To Fix Them

Deep-set eyes and hollow eyes are not the same. Find out how you can reduce it and regain bright eyes with the right treatment.

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What Are Hollow Eyes and Why Do They Happen?

First, let’s clear up a common myth: Deep-set eyes ≠ hollow eyes

Many people associate deep-set eyes with attractive features—think prominent brow bones and sculpted profiles. But deep-set eyes and hollow eyes are not the same. True hollow eyes happen when the fat around the upper eye socket starts to diminish. This can cause the upper eyelids to look sunken, leaving your face looking tired, aged, and low-energy—definitely not the best first impression.

Common signs of hollow eyes:

• Noticeable indentation along the upper eyelid
• Multiple eyelid folds or creases (“triple eyelids” or more)
• Darker eye area and more prominent tear troughs
• A widened double eyelid line
• Eyes appear fatigued or aged overall

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What Causes Hollow Eyes? Which Type Are You?

There are several reasons why hollow eyes can occur. Here’s a breakdown of the most common types:

• Genetics: Some people naturally have thinner fat around the eye area, making hollowness more likely.
• Aging: As we age, we lose collagen, and the eye socket bones may begin to recede. Fat may also shrink and sag, deepening the hollow look.
• Low body fat: If you’re naturally slim or have lost a lot of weight, fat loss in the face (including the eye area) is common.
• Eye strain: Constant screen time or frequent blinking can overwork the eye muscles and speed up fat depletion.
• Poor habits: Lack of sleep and late nights affect circulation around the eyes, which may worsen hollowing over time.
• Aesthetic surgery side effects: Over-removal of fat during double eyelid surgery or improper eyelid lifting procedures can result in visible hollowing.
• Trauma: Past injuries to the eye area can affect the structure of the orbital region.
• Eye diseases: Rare, but certain conditions like glaucoma or chronic dry eyes may indirectly impact orbital fat or tissue.

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Hollow Eyes Aren’t Just Cosmetic—They May Signal Deeper Issues

Ptosis (drooping eyelids) and hollow eyes: a muscle issue?

Drooping eyelids (ptosis) are often caused by weakened levator muscles, which are responsible for lifting the upper eyelid. When these muscles are weak, the eye compensates by redistributing nearby tissue, which can worsen the appearance of hollowness.

What is the levator muscle?

It’s the muscle that lifts your upper eyelid. When it's weak or sagging, the result is:

• Drooping eyelids
• Smaller, tired-looking eyes
• "Pseudo-hollowing" — an illusion of deeper-set eyes

Why does levator weakness make hollow eyes worse?

1. Shadowing effect: Drooping eyelids cast shadows in the eye socket, exaggerating the hollowed look — also called “skeleton eyes.”
2. Skin laxity and puffiness: Loose upper eyelid skin can droop and flatten natural contours, making the socket appear deeper.
3. Age-related fat loss: As levator function declines and fat begins to shrink, the combined effect leads to a visibly hollow and aged eye appearance.

You might need levator muscle surgery if you:

• Look tired or asymmetrical due to sunken eyelids
• Have sagging lids that partially block your vision
• Struggle with applying eye makeup because of uneven creases
• Tried fillers but saw limited results due to muscle-related sagging

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Bonus: Other Factors That Worsen Hollow Eyes

1. Receding eyeballs and eye bags

As we age, the ligaments that suspend the eyes weaken, and fat under the eyes can shift downwards into eye bags. This not only creates puffiness but also deepens the hollowing of the upper eye area.

This can affect people of any ethnicity or age group — it’s not just a concern for East Asians or older individuals.

2. Could it be a health issue?

In rare cases, eye diseases like glaucoma or chronic dry eye can contribute to structural changes in the eye area. If you're concerned, it’s best to consult an ophthalmologist or medical professional for an accurate diagnosis.

Is it dangerous?

From a health standpoint, hollow eyes are typically not harmful. The concern is more aesthetic—people tend to look more haggard, older, or exhausted than they actually are.

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Comparing Aesthetic Treatments for Hollow Under Eyes: Which One’s Right for You?

We’ve rounded up the most common aesthetic treatments for hollow under eyes—analyzing their effects, recovery time, and pricing to help you decide:

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Choosing the Right Surgery for Sunken Under-Eyes

If you’re considering fat grafting to treat under-eye hollowness, keep in mind that these three factors are key to success:

• Professional fat extraction technique: Skillful liposuction ensures high-quality fat for transplanting.
• Proper equipment and hygiene standards: Using medical-grade tools and sterile environments reduces the risk of infection.
• Precise multi-layer injection: Fat needs to be injected at the correct depth and position across multiple soft tissue layers for optimal results.

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Say No to “Overdone” Results—How to Get a Natural Look with Fat Grafting

1. Customised Treatment Planning

Talk openly with your doctor beforehand to assess your facial structure and goals. A personalised plan will be crafted—this may also include eye bag removal if needed.

2. Proper Fat Volume Is Key

Too much or too little fat can ruin the results. Overfilling may create bulges that later require surgical correction. Always check your doctor’s past cases to understand their approach.

3. Choose an Experienced Aesthetic Doctor

Review credentials, patient reviews, and—most importantly—real before/after photos. Don’t be misled by heavy makeup, filters, or ideal lighting. Look for raw, close-up shots of people your age or older, without beautification.

4. Combine with Other Eye Treatments for Maximum Results

• Brow Lift: Tightens sagging brows and enhances upper eyelid definition
• Eye Bag Removal: Eliminates puffiness and helps rejuvenate the entire under-eye area

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What to Know Before and After Eye Hollow Surgery

Pre-Surgery Prep:

• Avoid scheduling surgery during your period
• Stop taking blood-thinning medications
• Fast before surgery as instructed
• Disclose your full medical history

Post-Surgery Care:

• Apply cold compresses
• Avoid pressure or rubbing the area
• Refrain from intense exercise
• Take prescribed meds on schedule
• Eat light, balanced meals for better healing

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Multiple Eye Folds? Severe Sagging? R6 Eye Rejuvenation Treatment Can Help!

Do your eyelids have multiple folds or sag so much they partially cover your pupils? You’re not alone—8 out of 10 Hong Kong women show signs of weakened eye muscles. Loss of fat may cause extra folds and droopy eyelids, making the eyes look small and aged. In severe cases, sagging outer corners can even create a "triangle-eye" shape.

If you’re not keen on injections or surgery, R6 Miracle Eye Rescue Treatment offers a non-invasive alternative. Using triple-layered radiofrequency energy, it works from the surface down to deeper skin layers to:

✔ Reduce dark circles
✔ Stimulate collagen for tighter skin
✔ Dissolve excess fat in eye bags
✔ Firm and sculpt the under-eye area
✔ Smooth fine lines
✔ Depuff swollen under-eyes

The R6 Treatment is painless, non-invasive, and requires zero downtime. It’s more effective than concealer and safer than surgery or fillers.

Click the link below to learn more about R6 and check out the latest promotions—just 1 minute to fill out a form, and you may qualify for a free trial session!