lower eye region, how to diagnose and what procedures to do?

lurking truecel

lurking truecel

Fire
Joined
Jul 12, 2024
Posts
15,653
Reputation
23,037
Okey, lower eye, one of the most talked about features on this site, people wanting infras, fat graft, bleph, cantho etc. But how do you really know what to get, hopefully this guide might be to some help.

lets start with some important anatomy:

in the pic below you can see postive and negative vector, the green line is the orbital septum. It is a important piece here as its divides two area of fat pads on the inside of the eye(yellow) from the one on the outside(red). fat graft is grafted in the red area, and blepho removes fat and repositions it even on the inside of the septum(yellow area). This weakens with time and is weak from the start if infra or eye orbits are round enough.

1766082135544





okey, let continue with the problems, and there are two distinct problems, and one problem that often follow the other two problems:

I will show how it looks and the reason for it first, then how differentiate between the two distinct ones.

1. first distinct problem we have the hollow eyes look:

1766075573645

1766075601138


Hollowed eyes are characterized by a hollowing around the eyes, basically lack of fat for the most part, its often accompanied by a discoloration.

This makes the nasujugal groves more visible which is the line from the inner canthus down the cheek.



1766075743751


and the reason is you lack fat basically, in the region marked below
.

1766077200259


2. The second distinct problem one can have is excess skin or also known as under eye bags

1766076218056


1766076227898


1766076247559


The characteristics off a undereye bags is fat bulging out rather then the eyes being hollowed.

Both of them causes nasujugal grooves, but for diffrent reasons.

As we can see below the reason for eyebags is the weakining of the orbital septum. This happens naturally with age for many people but some are unlucky to have it in early age
.

1766076341022


3. The eye problem that is often accompanying this two problems is the schleral show.

1766076598071

1766076626057

1766076648289


the characteristics of schleral show is basically seeing the white under the pupils

The reason is either bad laxity or extremly bad infra bone, often both.






How do one differientiate between hollow eyes and under eye bags?

Many people on this forum often confuse this part.

basically it is:

-people with undereye bags has too much fat behind the orbital septum.

-and people with hollowed eyes just have problem with fat infront of the septum.

The photo below explains it anatomically, left is under eyebags and right is hollowed eyes. look at the purple rings and what they point too.

Under eye bags causes bulging of fat and therefore causes wrinkles and even some dicoluration as the veins are pushed outwards so they are placed shallowly.

hollow eyes have causes wrinkles because lack of fat, and when more fat in the cheeks it becomes a wrinkle. and discolouration comes from lack of fat covering the blood vessels.( some discoloration is just pigmentation and is a skin related thing treated with laser)
1766077929124




Surgical solutions:

Under eye hollows is lack of fat infront of the orbital septum or the general undereye region, so here fat grafting is the solution.

some fat grafting result:

1766080781681

1766081083428

1766081193813


under eye bags is because its too much fat or because the orbital septum is weak, this is fixed with blephoplasty and fat reposition, maybe additional fat grafting too.

result from bleph and fat repositioning:

1766081247501

1766081270458

1766081386184


Schleral show is because of lack of laxity in the under eye lid, this is fixed with a lateral canthoplasty, canthoplasty, canthopexy or some other kind of eyelid retraction procedure.

result from some lower eyelid retractions type surgeries:

1766081465353

1766081480248

1766081502566




But hello, what about the infra orbital implant, when should i consider this?

The reason someone would need a infra orbital implant or tear through implant is when a person has negative vector.

This is illustrated in the pic below that other people shared here too.

1766078758473


This will not solve the problem with hollowing or lower eye bags, but it can be used in combination with the other surgery solutions for that extra touch up and bone support.


Lack of bone might the reason for your problems and why the soft tissue is what it is, but the soft tissue will not be solved by bone augmentation.

WHY ONE SHOULD BE CAREFUL WITH SADDLE IMPLANTS, according to my critical view(Ai confirmed it if it means anything):


If you do a big saddle, you can cause mechanical harm to the orbital septum which can create schleral show and problems with time. This is the reason many surgeons dont want to do big saddles. because as you blink and move the eye the orbital septum will take damage.


1766079404261


Another thing is that with time you lose bone in the orbital and then the orbital septum will take even more mechanical stress. This is more a hypothetical but its worth thinking about and consider so you can make a good decision.






other good threads about under eye region:


 

Attachments

  • 1766075586246.png
    1766075586246.png
    450.7 KB · Views: 0
  • +1
  • Love it
Reactions: tweaqo, Sicilian Cyclops, Nahorscend and 12 others
Nice thread. Been thinking of doing fat grafting and a canthopexy, so seeing this helped simplify things
 
  • +1
Reactions: LTNUser and lurking truecel
Haven't read yet but it's lurking trucel can't be other than fax
 
  • +1
Reactions: LTNUser and lurking truecel
interesting, so when people talk about infra recession it is not usually the reason?
 
  • +1
Reactions: lurking truecel
interesting, so when people talk about infra recession it is not usually the reason?
I mean what is recession even? When does one have it and when does one not have it? Thats the thing, some people have good infra bones, or even overly so but still has hollowed eyes and lack of fat. And they can still get bulging fat from the weakening of the orbital septum. Is a person with rounded orbits more prone to all those things and most likely have them, 100%. But just like some people have better bones some people have better soft tissue.
 
  • +1
Reactions: LTNUser and killuacel
Okey, lower eye, one of the most talked about features on this site, people wanting infras, fat graft, bleph, cantho etc. But how do you really know what to get, hopefully this guide might be to some help.

lets start with some important anatomy:

in the pic below you can see postive and negative vector, the green line is the orbital septum. It is a important piece here as its divides two area of fat pads on the inside of the eye(yellow) from the one on the outside(red). fat graft is grafted in the red area, and blepho removes fat and repositions it even on the inside of the septum(yellow area). This weakens with time and is weak from the start if infra or eye orbits are round enough.

View attachment 4436613





okey, let continue with the problems, and there are two distinct problems, and one problem that often follow the other two problems:

I will show how it looks and the reason for it first, then how differentiate between the two distinct ones.

1. first distinct problem we have the hollow eyes look:

View attachment 4436360
View attachment 4436362

Hollowed eyes are characterized by a hollowing around the eyes, basically lack of fat for the most part, its often accompanied by a discoloration.

This makes the nasujugal groves more visible which is the line from the inner canthus down the cheek.



View attachment 4436368

and the reason is you lack fat basically, in the region marked below
.

View attachment 4436439

2. The second distinct problem one can have is excess skin or also known as under eye bags

View attachment 4436395

View attachment 4436397

View attachment 4436399

The characteristics off a undereye bags is fat bulging out rather then the eyes being hollowed.

Both of them causes nasujugal grooves, but for diffrent reasons.

As we can see below the reason for eyebags is the weakining of the orbital septum. This happens naturally with age for many people but some are unlucky to have it in early age
.

View attachment 4436404

3. The eye problem that is often accompanying this two problems is the schleral show.

View attachment 4436425
View attachment 4436426
View attachment 4436427

the characteristics of schleral show is basically seeing the white under the pupils

The reason is either bad laxity or extremly bad infra bone, often both.






How do one differientiate between hollow eyes and under eye bags?

Many people on this forum often confuse this part.

basically it is:


-people with undereye bags has too much fat behind the orbital septum.

-and people with hollowed eyes just have problem with fat infront of the septum.

The photo below explains it anatomically, left is under eyebags and right is hollowed eyes. look at the purple rings and what they point too.

Under eye bags causes bulging of fat and therefore causes wrinkles and even some dicoluration as the veins are pushed outwards so they are placed shallowly.

hollow eyes have causes wrinkles because lack of fat, and when more fat in the cheeks it becomes a wrinkle. and discolouration comes from lack of fat covering the blood vessels.( some discoloration is just pigmentation and is a skin related thing treated with laser)
View attachment 4436473



Surgical solutions:

Under eye hollows is lack of fat infront of the orbital septum or the general undereye region, so here fat grafting is the solution.

some fat grafting result:

View attachment 4436578
View attachment 4436585
View attachment 4436587


under eye bags is because its too much fat or because the orbital septum is weak, this is fixed with blephoplasty and fat reposition, maybe additional fat grafting too.

result from bleph and fat repositioning:

View attachment 4436589
View attachment 4436590
View attachment 4436593


Schleral show is because of lack of laxity in the under eye lid, this is fixed with a lateral canthoplasty, canthoplasty, canthopexy or some other kind of eyelid retraction procedure.

result from some lower eyelid retractions type surgeries:

View attachment 4436595
View attachment 4436597
View attachment 4436598



But hello, what about the infra orbital implant, when should i consider this?

The reason someone would need a infra orbital implant or tear through implant is when a person has negative vector.

This is illustrated in the pic below that other people shared here too.

View attachment 4436501

This will not solve the problem with hollowing or lower eye bags, but it can be used in combination with the other surgery solutions for that extra touch up and bone support.


Lack of bone might the reason for your problems and why the soft tissue is what it is, but the soft tissue will not be solved by bone augmentation.

WHY ONE SHOULD BE CAREFUL WITH SADDLE IMPLANTS, according to my critical view(Ai confirmed it if it means anything):


If you do a big saddle, you can cause mechanical harm to the orbital septum which can create schleral show and problems with time. This is the reason many surgeons dont want to do big saddles. because as you blink and move the eye the orbital septum will take damage.


View attachment 4436523

Another thing is that with time you lose bone in the orbital and then the orbital septum will take even more mechanical stress. This is more a hypothetical but its worth thinking about and consider so you can make a good decision.






other good threads about under eye region:


Enjoyed reading it since many people confuse the procedures, pretty realistic explanation with actual research behind it (since i know you as a user).
 
  • +1
Reactions: lurking truecel
we need looksmaxxing professionals as a new job title , just like fitness trainers or law consulting , an individual who's an expert on looksmaxxing giving people advices and shit , it has to be irl in an office .
 
off topic but did bimax improve your nasiolabal folds drastically
 
  • +1
Reactions: lurking truecel
@lurking truecel

i remember you being one of the first people i talked to when i joined this forum lmao, so i js wanted to thank you for being helpful

secondly, iv'e seen alot of people talking shit about wrap around zygo - infraorbital (cheekbone) implants and i was wondering why. also what would be better implants or fat grafting OR both. i however was planning to get implants.
 
  • +1
Reactions: lurking truecel
@lurking truecel

i remember you being one of the first people i talked to when i joined this forum lmao, so i js wanted to thank you for being helpful

secondly, iv'e seen alot of people talking shit about wrap around zygo - infraorbital (cheekbone) implants and i was wondering why. also what would be better implants or fat grafting OR both. i however was planning to get implants.
I mean its hard to get right and wont solve the soft tissue but if you can do both ots better
 
  • +1
Reactions: high_ltn
off topic but did bimax improve your nasiolabal folds drastically
Not drastically but relatively much. But there are certain movements that helps with it more then others. Impactions can make it worse for example and ccw too. Without much forwardadvancement
 
  • +1
Reactions: Sicilian Cyclops and LEFORT17
Not drastically but relatively much. But there are certain movements that helps with it more then others. Impactions can make it worse for example and ccw too. Without much forwardadvancement
u think big pog advancements can have an impact on nasiolabal folds?
 
  • +1
Reactions: lurking truecel
i dont have any but im thinking that the huge rotation might have an somehow negative impact on the midface
I mean rotations folds the face basically so it can have some negative impact if you dont move maxilla forward to cpunteract
 
I mean rotations folds the face basically so it can have some negative impact if you dont move maxilla forward to cpunteract
surgeon told me he will move my upper incisors as much forward so that the ans wont fall back posteriorly due to rotation. sounds good so far
 
  • +1
Reactions: lurking truecel
Seems like a good thread.

Bimax advancement itself seems to improve that “cheek line” that defines orbital vector in most cases though if you look at B&A side profiles, there must be more to it.

Extreme example:

IMG 8770
 
Last edited:
  • +1
Reactions: lurking truecel
If you have negative vector and do infra implant but non-saddled I wonder if it will make the issue worse instead of better by creating a step-off under the eye. But I guess you can fat graft to cover that. I wanna do saddle but even a conservative one feels risky, there seems to be no long-term data on how it will age because it's pretty new.
 
  • +1
Reactions: lurking truecel

Similar threads

asdvek
Replies
14
Views
476
ssxjdgh
ssxjdgh

Users who are viewing this thread

Back
Top