Under-Eye Hollows: Why They Form and How to Address Them
The hollow groove beneath the lower lid that creates persistent shadows and a tired appearance. Addressed with precision.
get startedThe hollow groove beneath the lower lid that creates persistent shadows and a tired appearance. Addressed with precision.
get startedUnder-eye hollows are depressions that form in the tear trough area — the groove between the lower eyelid and the upper cheek. They create shadows that read as dark circles and give the eye area a sunken, tired quality that persists regardless of how much sleep a patient gets.
They're distinct from under-eye bags (which involve fat herniation forward) and from pigment-based dark circles (which involve melanin in the skin). Under-eye hollows are a structural concern that requires structural treatment.
Patients with under-eye hollows almost universally describe the same experience: they always look tired, even when they're not. The shadow created by the hollow makes the eyes look sunken and gives the whole face a fatigued quality that affects how others perceive them in conversation and photographs.
Under-eye hollows develop from structural changes in the periorbital area.
Fat pad thinning: The sub-orbicularis oculi fat (SOOF) and the orbital fat beneath the lower eyelid thin with age. This deflates the under-eye area and creates a visible depression.
Orbital rim remodeling: The bone of the orbital rim widens and remodels over time, increasing the visual depth of the tear trough groove.
Skin thinning: The skin beneath the eye is among the thinnest on the body and becomes increasingly translucent with age, making the hollow and underlying vasculature more visible.
Cheek descent: As the mid-face descends, it pulls away from the lower lid, deepening the transition between the eye and the cheek.
Patients with under-eye hollows typically notice one or more of the following:
In the 20s, the under-eye area is typically smooth with a seamless transition from the lower lid to the cheek. Most people have no structural hollowing at this stage.
Through the 30s, the first suggestion of a tear trough groove emerges as the orbital fat begins to thin. Most patients notice this as persistent shadows that don't resolve with sleep.
Through the 40s and beyond, the hollow deepens as fat pad thinning continues, the orbital rim remodels, and the cheek descends further from the lower lid. The combination creates a pronounced under-eye shadow that significantly ages the face.
Under-eye hollows require careful, technically precise treatment.
At CAMI, tear trough treatment begins with the cheeks. Before placing anything near the eye, we assess whether restoring mid-face volume will improve the hollow without directly treating the tear trough. In many cases it does — and it's safer.
When we do treat the tear trough directly, we use the softest appropriate product, placed conservatively, in the correct tissue plane. The Tyndall effect — a bluish discoloration that results from filler placed too superficially — is a preventable complication that results from incorrect technique. We prioritize caution over volume in this area every time.
Care guided by experience, precision, and a deep understanding of natural beauty.
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Meredith is the absolutely best!! She is so sweet and her work is perfection! Always an amazing experience at CAMI! Highly recommend.
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I have been coming to CAMI for 5 to 6 years now and their service is bar none! I’m always exceptionally pleased with my results, as I rotate Botox and Xenomin. The staff are very friendly and I always make me feel right at home!
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Ashley at CAMI has been amazing. She made me feel comfortable before, during and after my treatments and helped me feel more confident in my appearance
I saw Madison for my Botox appointment and she was the best! She listened to my concerns and I’m very pleased with the results. She also recommended some great skincare products! Can’t recommend this office enough!
I had a wonderful experience with Madison Mikolajczyk,. From the very beginning, she explained everything about my face in detail and with such professionalism that I immediately felt comfortable. I truly appreciated her honesty in telling me exactly what I needed and what would work best for my features. She performed my filler injections using the cannula method and normal injections which left me with beautiful, natural-looking results—and no bruising at all. No one can do that using that method with no bruising. The entire process was completely painless, as she took her time and worked so gently.I couldn’t be happier with the outcome. My results are subtle, natural, and exactly what I hoped for. I’m truly in love with the way my face looks now and would highly recommend her to anyone seeking safe, professional, and natural enhancements. I did Sculptra, Botox and Radiesse filler looking forward for more.
I’ve had nothing but a great experience at CAMI! Ashley is amazing at what she does, as someone who has never gotten any kind of injections before, she was very knowledgeable explaining everything to you beforehand, and will make you feel as comfortable and confident as possible!
I have been very happy with my services over the past few months. Meredith is so sweet and always makes my time there very comfortable. She is patient with me and never pushes me into anything I’m not comfortable with regarding my skin.
I love visiting the CAMI location in Huntersville! They treat everyone special and I left feeling refreshed and uplifted. It was my first time meeting Katie, and she was spectacular! She spent time addressing my needs and concerns and I will definitely request an appointment with Katie again. Thank you CAMI!!
Very personable fun atmosphere and relaxing. Normally I go to California for my facials but I feel very good going to CAMI in Huntersville for my beauty needs.
Easy to schedule consult and treatments! Wonderful welcoming staff at CAMI who make you feel relaxed and excited to be there. Will continue to choose CAMI for all cosmetic needs and recommend to everyone!
This is a great place to come for any facial treatments, fillers, etc. The staff is excellent and I felt totally pampered.
The team is awesome. The staff takes great care of me. I would highly recommend CAMI.
The team was amazing. This was my 1st time getting Botox. They were very thorough and informative. They made the experience easy.
Their team is highly skilled and very good at what they do. I have never had any type of facial treatments before and decided it was time for a little pick-me-up. They took the time to listen to my concerns and recommended the procedure that was best suited for the outcome I was wanting.
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I was honestly skeptical about trying CAMI since I hadn’t had the best experiences with Botox and other treatments elsewhere. But choosing CAMI turned out to be one of the best decisions I’ve made. Madison, in particular, is the best nurse and injector I’ve ever worked with—she’s honest, genuinely cares about your results, and makes you feel like her top priority. While the treatments are an investment, as we age a little extra care and attention truly go a long way.
I Love CAMI, and all there staff! Katie Wilson is the absolute Beauty Making Queen!!! 👑 She is very particular when she was doing what I asked of and the results are perfection. I have recommended CAMI to multiple people and they are just as please. Thank you CAMI
I’m so glad I gave this med spa another chance. Everything feels completely different now in the best way. I had a hydrafacial and hydr with Meredith and noticed an immediate improvement in my skin. I went back and purchased a microneedling package, and the results have been good so far. Meredith truly made my experience there so much better. She made me feel comfortable, welcomed, and kept me laughing the entire time. She is also very honest, which I really appreciate. I’ve finally found my person, and I won’t let anyone else touch my face. Highly recommend!
