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Upper eyelid contouring

As we get older, many of us develop hollow-looking, sunken upper eyelids. People who have had upper eyelid surgery to improve the appearance of heavy or hooded lids (blepharoplasty) may eventually find that their upper eyelids start to look hollow.

The sunken look is caused by the loss of volume in the soft tissue of your upper eyelids. In some cases, where excess skin has been tightened or removed from the eyelid, the appearance of the upper eye socket can become skeletal over time.


Hyaluronic acid (HA) gel has been used for some years to fill lines and increase facial volume. More recently, Mr Malhotra became one of the pioneers in the UK of its use in filling under-eye hollows, known as tear troughs. It can now be used to improve the contours of the upper eyelid, restoring a more youthful and rested appearance.

Hyaluronic acid occurs naturally in the skin, so HA gels are compatible with the skin's own hyaluronic acid and combine to improve skin elasticity and create volume. HA gel breaks down gradually and naturally and, depending on the patient, will disappear completely, generally between four and 12 months later. The effects of HA gel can also be reversed by injecting a neutralising agent.

Mr Malhotra is a highly experienced practitioner in HA gels. In a study that he co-wrote, 96 per cent of patients treated with HA gel for upper eyelid contouring were happy with the results.

Upper eyelid contouring is a simple process. The skin on your upper eyelids is numbed with ice and wiped with an alcohol swab. You sit in a chair and are asked to look down.

The HA gel is then inserted in a series of three or four micro-injections of 0.1 ml or less of gel into the eyelid. You are then asked to raise your eyebrows and Mr Malhotra moulds the HA gel filler by hand to create a smooth look. When your eyebrows are relaxed, Mr Malhotra assesses the result. If they are any lumps or irregularities, he will carry out further moulding.

Because HA gel is naturally absorbed by the body over time, upper eyelid contouring needs to be repeated, or the sunken look will return.

"Dear Mr Malhotra, I am just writing to express my sincere gratitude for what you have done for me, regarding the upper eye fillers. After all I had been through and the many ops, I had lost hope of ever really looking like myself again, but even my Mother remarked at the weekend how I actually had started to resemble the old me, since my treatment with you."

"The Restylane has settled beautifully and brought the more almond shape back to my eyes as they were originally. Having spent 5yrs hiding behind sunglasses I was able to enjoy the rest of the Summer since my visit without them. Out of all my surgeries to restore functionality, which I of course was grateful for, this is actually the first time anyone addressed the aesthetic and it really has made such a huge difference to my wellbeing that I wanted to write and thank you for your time, understanding and expertise. To be honest I really can't thank you enough even if I wrote daily."

upper eyelid contour pre
Before upper eyelid conturing

upper eyelid contour post
After procedure

What to expect

  • After the procedure, you may feel slightly sore at the site of the injections.
  • You will develop some bruising and swelling — this is quite normal and usually disappears within five days.
  • If you are embarrassed by the bruising, use concealer or sunglasses.
  • A small number of patients may need more HA filler injected some weeks later to get the effect they want.
  • The effects of HA gel last for approximately 12 months in most patients, which means that the procedure must be repeated if you do not want the sunken-eyed look to return.
  • Do not exercise or drink alcohol for 24 hours after the procedure.
  • Avoid bending down for six hours after the procedure.
  • Do not put direct pressure on your eyelids for 72 hours after the procedure, to allow the HA gel to stabilise.

All procedures begin with a consultation. For full information about what to do before and after surgery, see Patient information.

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Lip filling and shaping

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Tear trough fillers

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Upper eyelid contouring

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Mohs surgery

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Ptosis surgery


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