What Is The Best Way To Treat Undereye/Midface Hollowing?

Q: Dr. Eppley, I’m a young male and I am not happy about my mid face/under eye area. I’m not sure if I need implants, fat transfer or if my bone structure is weak. Also my forehead bone looks like it excessively sticks out and it’s narrow at the sides. I did consider bone shaving because I also don’t have much of a brow bone like males do. I was unsure because I was told by a surgeon that my mid face is weak that’s why the forehead looks prominent.

Also, is there anything that can be done about the fat coming down at the sides of my nose (nasolabial folds… I think), can the fat or tissue be repositioned?

A: In answer to your questions:

  1. You have a relatively significant undereye (infraorbital-malar, IOM) bony deficiency.
  2. For which fillers and fat injections are both ineffective and not good treatment for it.
  3. Only custom IOM implants can make a reliable and effective improvement.
  4. Your nasolabial and the tissue above them reflects the lack of IOM bony support above it which allows this tissue to ‘fall down’ onto the nasolabial folds. Such fallen heavy tissue can not be repositioned but IOM implants may help lift it a bit.

Dr. Barry Eppley

World-Renowned Plastic Surgeon