Journal · Aesthetic Medicine
Hollows, bags, skin colour, fluid or thin skin: why dark circles have different causes, the one that filler helps, the ones it makes worse, and what to do instead.
People keep asking if you are tired, even when you slept well. Concealer helps for an hour, then the shadows come back. You have heard that under-eye filler can fix it, and you are wondering if it is right for you.
Sometimes it is. But dark circles have several different causes, and filler only fixes one of them. This is the treatment I say no to most often, and here is why.
Dark circles can come from a hollow groove, puffy bags, darker skin colour, fluid, or thin skin. Filler helps only when the main problem is a true hollow. For the other causes, filler can make things look worse, not better. A careful examination decides whether filler is the answer, or whether something else will help more.
When I look at a tired under-eye, I am asking which of these is going on. Most people have more than one.
A simple test you can try at home: stand under a ceiling light and look in a mirror, then tilt your head back slightly. If the darkness mostly disappears, a hollow may be the main cause. If it stays the same, colour or thin skin is more likely.
If the main problem is a true hollow, a small amount of soft hyaluronic acid filler can smooth the step between the lower eyelid and the cheek. Hyaluronic acid is a gel that holds water, and it can be dissolved if needed.
Sometimes the better answer is not under the eye at all. A flat cheek can drag the area down. Restoring a little support in the cheek can soften the under-eye without putting anything in the groove.
The skin under the eye is thin and the area has important blood vessels nearby. Risks include:
Because the filler is hyaluronic acid, it can be dissolved if something is not right.
I examine you sitting upright, under light from above and from the side, at rest and smiling. I gently pinch the skin to check its thickness and feel for bags. I take photos before anything is decided.
If filler will not help you, I will say so, and tell you what will, even if it is not something I provide. I would much rather say no than give you a result you spend a year trying to undo.
Only if the main cause is a hollow groove. It does not change skin colour, bags or thin skin.
I use numbing cream, and the filler contains a local anaesthetic. Most people feel pressure more than pain.
Commonly about nine to eighteen months in this area, depending on the product and your body.
Filler can hold water, especially in people prone to puffiness, or if too much was used. It can be dissolved.
Daily sunscreen, prescribed brightening creams and sometimes gentle peels. Progress is slow but can be real.
This article is general information, not medical advice for you personally. Results vary between individuals, and every treatment needs a face-to-face consultation with a licensed doctor first, so we can talk about your health, your goals and the risks.
Read more on my under-eye filler in Dubai page, or book a consultation.
Consultations at Soleá Clinic, Dubai, are by appointment. We discuss whether a treatment is right for you before anything is booked.
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