Under eye hollows occur as a result of loss of volume (bone and/or fat pads) under the eye area. Symptoms include dark circles, fine lines and wrinkles creating a tired, sunken appearance.

Under-eye Hollows (Sunken Eyes)

What are sunken eyes?

Sunken eyes, or under-eye hollows, is a condition where the area under the eyes appears recessed, creating a shadowed or hollow look.

This change in the appearance of the under-eye area can result from ageing, dehydration, lifestyle factors, or genetic predisposition.

At Dr Nerina Wilkinson + Associates, we understand the nature of the under-eye area and offer tailored non-surgical treatments to rejuvenate and restore its appearance.

Learn about the types of conditions associated with sunken eyes and the types of treatments we provide to help patients address under-eye hollows and enhance their facial appearance. You can also contact us to book your consultation today.

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Conditions Associated with Sunken Eyes

At Dr. Nerina Wilkinson + Associates, we excel in identifying and addressing various conditions that lead to sunken eyes, customising each treatment to our patient’s unique needs.

Our proficiency in aesthetic medicine enables us to offer a range of solutions and advice for causal conditions like volume loss, dehydration, lifestyle factors, genetics, medical conditions, weight loss, pigmentation, and trauma. These treatments aim to rejuvenate the under-eye area, enhancing facial aesthetics.

With our extensive knowledge of factors contributing to under-eye hollows, combined with our dedication to advanced therapeutic approaches, we are committed to effectively managing undereye hollows. Our goal is to boost our patients’ self-esteem and restore the natural beauty of their under-eye area.

Learn more about the types of conditions we treat below and contact us to book your consultation.

Volume loss due to ageing

Volume loss, a common sign of ageing, occurs when the natural fat and collagen under the eyes diminish. This reduction creates a hollow appearance, emphasising ageing. Effective treatments aim to replenish lost volume, rejuvenate the under-eye area, and restore a youthful, refreshed look.

Vitamin deficiency

Vitamin deficiencies, particularly in vitamins C, K, and E, can lead to under-eye hollows and dark circles. These nutrients are vital for skin health and elasticity. Addressing these deficiencies through diet, supplements, or specialised treatments can significantly improve under-eye appearance.

Weight loss

Significant weight loss often results in reduced facial fat, particularly around the eyes, leading to under-eye hollows. This loss of volume can produce a tired, aged appearance. Treatments focused on restoring under-eye fullness can counteract this effect.


Pigmentation under the eyes can accentuate the appearance of sunken eyes, creating dark circles. This discoloration may be due to genetics, ageing, or lifestyle factors. Targeted treatments can help lighten these areas, improving overall under-eye appearance and skin tone.

We provide the following

Types of Treatments for Under-eye Rejuvenation

At Dr. Nerina Wilkinson + Associates, we excel in providing advanced treatments for undereye rejuvenation, tailoring each procedure to our patients’ specific concerns.

Our expertise in aesthetic medicine guides our approach to achieving optimal results with a range of treatments, including Lipofilling, Dermal Fillers, Mesoboosters, Chemical Peels, 3D Medical Needling, Periocular Brightening Peels, and many more. These procedures are designed to rejuvenate the under-eye area by restoring volume, improving skin texture, and reducing the appearance of hollows and dark circles.

Our team’s experience in addressing under-eye concerns, combined with our dedication to the latest therapeutic techniques, ensures effective treatment of various under-eye conditions. We are committed to enhancing our patients’ confidence and revitalising the appearance of their under-eye area.

Learn more about the types of treatments we provide for sunken eyes and contact us to start your journey towards a renewed and rejuvenated under-eye appearance.

Dermal Fillers

Dermal Fillers are available to create a bespoke rejuvenation or preventative treatment plan for every patient.
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Chemical Peels

Our Chemical Peel Treatments are specifically designed for patients who want a more even complexion with an instant bright and healthy glow.
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3D Medical Needling

This exclusive treatment has been specifically designed for clients who wish to treat the signs of ageing and naturally increase the collagen content of their skin.
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Periocular Brightening Peel

This indication-specific combination peel, together with microneedling, forms part of the exclusive periocular protocol for superior results around the eye area.
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Lipofilling (Fat Grafting)

Precisely transplant fat and stem cells to the face at different levels & layers to improve facial contours and create an uplifting effect.
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Mesoboosters aim to counteract and delay signs signs of ageing, providing immediate aesthetic enhancement and sustained rejuvenation.
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Frequently asked questions about conditions & treatments associated with sunken eyes

What causes sunken eyes (under-eye hollows)?

Sunken eyes are primarily caused by volume loss (bone and/or fat pads) in the under-eye area, often due to ageing. Other contributing factors may include dehydration, poor nutrition, lack of sleep, genetics, certain medical conditions, and lifestyle factors such as smoking and high stress.

What medical conditions may cause sunken eyes?

Various medical conditions can contribute to the development of sunken eyes. These include dehydration, sinus infections, allergies, thyroid disorders, and nutritional deficiencies. Additionally, conditions that lead to rapid or significant weight loss can also result in sunken eyes.

At Dr. Nerina Wilkinson + Associates, we start with a comprehensive consultation to accurately assess each patient’s underlying causes of sunken eyes. This consultation helps us understand the specific factors that might be causing your condition, enabling us to provide the most effective and personalised treatment options. Schedule your consultation today to begin addressing your undereye rejuvenation needs with our expert guidance.

What deficiencies cause sunken eyes?

Sunken eyes can often be attributed to deficiencies in certain essential nutrients that are crucial for skin health and facial structure.

Notably, a lack of Vitamin C, which is vital for collagen production, can lead to a loss of elasticity and fullness under the eyes.

Similarly, deficiencies in Vitamin K, which affects blood circulation, and Vitamin E, important for skin repair and protection, can exacerbate the appearance of sunken eyes. Vitamin A, necessary for skin regeneration and hydration, also plays a significant role.

Additionally, iron deficiency, which can cause anaemia, often results in a pale and tired look around the eyes.

Addressing these nutritional deficiencies, either through diet or supplementation, can significantly improve the condition and appearance of sunken eyes.

How to rejuvenate undereye hollows

Dermal fillers are a highly effective non-surgical treatment to “fill” sunken eyes and revitalise the under-eye area.

At Dr. Nerina Wilkinson + Associates, we use hyaluronic acid-based fillers, one of the best options for this purpose. Hyaluronic acid is a naturally occurring sugar found in the body’s tissues. By adding volume using dermal filler injections, it not only enhances facial proportions but also delivers essential nutrients and retains moisture, resulting in softer, plumper skin.

For those requiring a more advanced (or often just a different) approach, we might recommend a surgical Lipfolling (Fat Grafting) procedure where the body’s own fat is purified and injected into the areas of concern.

For a personalised consultation and to explore treatments that can rejuvenate the area under your eyes, book an appointment with our team of Aesthetic Doctors.

How do I choose the right treatment for sunken eyes?

Choosing the right treatment for sunken eyes begins with a professional consultation with qualified and experienced specialists. This essential step allows for a thorough analysis of your facial features, helping you and your specialist understand your specific concerns and goals.

At our clinic, we offer a unique and comprehensive Aesthetic Couture Consultation. This consultation enables you to discuss and analyse your concerns and aspirations in depth. Our team of experts will then provide personalised advice, focusing on the particular characteristics of your undereye area. This careful evaluation is crucial in developing an effective treatment plan tailored to your needs.

Schedule your Consultation with us today to take the first step towards addressing your sunken eyes with the most suitable treatment.

Are hollow under-eyes permanent?

Hollow eyes are not necessarily permanent. They can result from ageing, lifestyle factors, or genetics. Treatments like dermal fillers, lifestyle changes, and skincare can often improve their appearance. However, the permanence of hollow eyes varies from person to person, depending on the underlying cause. It’s important to consult with a healthcare professional for a personalised assessment and treatment plan.

Can Botulinum Toxin fill under-eye hollows?

Botulinum Toxin is not typically used to fill under-eye hollows. It’s primarily utilised to relax muscles and reduce wrinkles on the skin. For under-eye hollows, dermal fillers are more commonly recommended as they add volume and reduce hollowness. Each treatment option varies based on the individual’s needs, so it’s important to consult with an Aesthetic Doctor to determine the most effective approach for your specific concerns.

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Sunken eye treatment consultation

At Dr. Nerina Wilkinson + Associates, we specialise in bespoke solutions for sunken eyes, blending cutting-edge techniques and deep expertise. Our aesthetic skincare experts offer precise, tailored treatments to rejuvenate your under-eye area.

Reach out to book your consultation at our private practice at the V&A Waterfront in Cape Town.