Temple Hollowing: Why Eyes Look Smaller?

For Those in Their Late 30s Who Notice Their Eyes Looking Smaller in the Mirror

Every change of season, more patients come to my office

showing me their selfies and asking,

"Why do I look so tired these days?"

Many say, "I'm thinking about getting

eye shape correction surgery,"

but often the real issue isn't with their eyes at all.

Today, I'll explain why this happens step by step.

They may look similar, but the key lies elsewhere

Temple hollowing refers to

volume loss from the outer eyebrow area

all the way to the front of the ears,

creating a sunken appearance.

Unlike cheek hollowing,

temple hollowing often goes unnoticed by patients themselves.

That's because we primarily look at ourselves straight-on in mirrors.

But when you wonder in photos or side profiles,

"Why do I look so angular?"

this area is often the culprit.

Understanding this difference makes choosing easier

When temples become hollow,

eyes appear smaller and

facial contours look more angular.

Just restoring volume in this area

can simultaneously transform both eye appearance and facial contours.

Last month, a 46-year-old woman came in

requesting a consultation, saying

"I want surgery to lift my droopy outer eye corners."

But when I examined her, rather than the eyes themselves,

I noticed her temples were sunken

by more than 5mm on both sides.

When this area becomes hollow,

the support structure for the outer eyebrows collapses,

making the eye corners appear droopy,

while simultaneously breaking the

smooth curve from forehead to cheekbones,

making only the cheekbones appear to protrude.

Hollowing in one area

simultaneously undermines three aspects of your appearance

(eye size, eye corner angle, and facial contours).

Anatomically speaking,

the temple area has subcutaneous and deep fat layers

thinly covering the upper temporalis muscle,

and the deep fat layer begins to diminish from the mid-to-late 30s.

This results in subtle 1-2mm depressions

that absorb light,

making the area appear more sunken than it actually is.

Instead of eye surgery for that patient,

I injected just 1cc of Filler into each temple.

When she returned two weeks later,

she was amazed herself.

"My eyes look bigger," she said.

Even though we hadn't touched her eyes at all.

Here's how I approach this in my practice

I categorize patients into three approaches

based on the degree of hollowing and skin condition.

But this isn't without considerations.

The temple area has the temporal artery running through it,

so incorrect injection depth and placement

can pose vascular complication risks.

That's why I only inject slowly with a cannula,

right above the periosteum.

Injecting too much at once out of impatience

can actually make the area look overly prominent.

However, even considering these risks,

the dramatic improvement with virtually no downtime

makes this an excellent choice for a first volume procedure.

Three most frequently asked questions in my office

Q1. Won't Filler injections make my forehead or upper eyelids look puffy?

A. That can happen if you exceed the appropriate amount.

The standard for temples is 0.8-1cc per side.

Exceeding this can make the forehead sides appear bulky

or the upper eyelids look heavy.

I typically start with about 0.7cc,

then add more after 4 weeks if enhancement is needed.

Q2. How long do the results last?

A. It varies by product and individual factors,

but hyaluronic acid fillers typically last 12-18 months,

while Sculptra lasts over 2 years.

However, temples tend to absorb fillers

slightly slower than other facial areas

because there's less movement in this region.

Q3. What's the likelihood of side effects?

A. The main concern is vascular-related complications.

Since the temporal artery runs superficially in some areas,

a doctor with precise anatomical knowledge

must inject above the periosteum using a cannula.

You may experience mild bruising or

a feeling of pressure for 2-3 days after the procedure,

but this typically subsides within a week.

If you have any questions, I'll be happy to examine you directly in my office and provide guidance. This has been Dr. Wi Young-jin.