A sunken upper eyelid happens when there is volume depletion on the upper eyelid area. This makes the upper eyelid appear hollow with deep shadow, possibly higher eyelid crease and more visible outline of the underlying orbital bone.
Since a youthful eyelid is characterized by its fullness, a sunken upper eyelid makes the eye look tired and older.
Sunken upper eyelid can be caused by multiple factors:
Genetic – Some people are born with a more prominent brow bone and deep set eyes, or they have strong bone structure that is in disproportion to their soft tissue.
Ageing – A person naturally loses bone mass and subcutaneous fat (volume) as they age, and with thinning of the skin it makes the condition more noticeable.
Excessive surgical removal of orbital fat – Double eyelid surgery that is common in Asian countries as well as surgery to address drooping eyelids usually involve cutting away excess skin and removing fat. If too much fat is removed it can lead to or exacerbate the problem of sunken upper eyelid.
Trauma – When there is trauma to the eye area - for example a bone fracture, it may cause fat atrophy resulting in volume loss on the upper eyelid area.
The correction of upper eyelid involves volume augmentation with HA filler (Hyaluronic Acid) At GEM Clinic we use Juvéderm® fillers which are injected into the upper eyelid area to replace the volume loss. It is a minimally invasive, straightforward and fast procedure.
The result of Juvéderm® filler usually lasts for 1.5 to 2 years.
Risks associated with using Juvéderm® are redness, swelling, bruising, tenderness or itching sensation in the treated area. These common side effects typically resolve within a few days. Occasional cases of bumps and pimples, sometimes accompanied by redness, may occur a few days to a few weeks after the injection. These are temporary and generally disappear spontaneously in a few days.
Rare cases of abscess, granuloma and blocking of blood vessels causing damage to the surrounding skin have been reported. Very rare cases of reversible discolouration at the injection sites have also been described for Hyaluronic acid injections. However, the risk of developing a serious complication is small.
Fat graft is another option in treating sunken upper eyelid. It involves extracting a little of the client’s own fat from elsewhere in the body and injecting it back into the upper eyelid area. It is not as simple as using a filler as it involves the additional steps of fat harvesting and separating the fat from the blood and tumescent solution.
With fat grafting, the result is less predictable as the percentage of fat cells that survive is dependent on the quality of the client’s fat, the surgeon’s skill and processing method. There is more swelling and the duration of the procedure is around an hour.
If more than 50% of harvested fat cells survived, the result from a fat graft lasts 2 to 3 years.
There is no direct correlation between nutrition and sunken upper eyelid. However, adequate hydration and good nutrition will lead to better skin condition.