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Note: ASAPS cannot give advice about specific medical problems nor should answers provided by responding surgeons be substituted for a complete medical history, work-up and an in-personal medical/surgical consultation. Sorry we can't answer all questions. We try to select questions that have the widest general interest.
It would appear that my eyes are sinking in my head. Is this normal with aging?...
Anytime a patient complains of changes around the eyes, having an ophthalmologist's examination to rule out any serious pathology is important. It is good that your ophthalmologist found all is normal.
One then needs to evaluate the entire face and concentrate on the periorbital area. This includes the bony structure, the soft tissue, level of the eyelids, and position of the eyelids. After doing this, any changes should be noted. As we age, we do lose fat in the face, as well as around the eyes. Loss of fat is probably the most common cause of hollow eyes. The treatment is directed then towards the cause to reverse the aging process. This may mean filling the periorbital area with filler or preferably, in my practice, micro fat droplets. A brow lift and a facelift may also be needed.
All these options and potential rejuvenation results would be discussed by a Board Certified Plastic Surgeon with the patient, along with risks and complications. Then an informed decision can be made.
There are some volume related issues with aging. Lots of patients experience a decreased volume of the fat pockets around the eyeball and face, as well as a diminution of facial bone volume which could include an enlargement of the eye socket space and a backward movement of the globe.
Structural fat grafting provides a means for restoring or enhancing this 'brow roll' area. In patients that have always had, or who with age have developed a deep recess between the upper lid and brow, the addition of soft tissue volume can dramatically rejuvenate the appearance of the eyes. This novel aesthetic enhancement of the upper lids does not look like eyelid surgery – it just looks youthful.