It’s something that affects many. Tired eyes and dark circles.

Do you always look like you had a bad night’s sleep (or a big night out!)?

Do people constantly ask you if you are tired?

What causes dark circles?

There are three main causes of constant dark circles under the eyes. Some people actually develop sun damage pigment in this area, which can be treated with skin care products, IPL or similar.

Some people genetically have thinner tissues under the eyes, allowing the vessels to be more visible and causing a bluish discolouration. But the most common cause is some lack of volume in the tissues.

Often the dark look is nothing more than a shadow effect from this volume loss – you might notice that things tend to look a lot worse with a downlight above you, and much better with lighting from the front, or when your photo is taken with a flash (Flash lighting tends to fill in lines and hollows and minimise their appearance).

These last two causes of dark eyes are often a genetic feature and seen from a relatively young age, and can often be treated effectively with specialised dermal fillers.

The result is generally a very refreshed appearance.

What dermal fillers are used under the eyes?

At Envisage clinic we use special dermal fillers for this area.

There is only one dermal filler that is specifically manufactured for this indication.

This dermal filler is made from a natural substance, present in our bodies.

It is very soft, so it tends not to cause lumpiness, and generally does not cause water retention or swelling.

It also contains natural anti-oxidants to help combat the darkness.

How are treatments performed?

Generally low volumes of filler are required. They can be placed with a very tiny needle or with a fine cannula.

Somewhat surprisingly these treatments are generally very painless.

How long do dermal fillers under the eyes last in the tear trough?

As with all treatments this can vary individually.

This is an area where fillers tend to last very well, so although the stock answer to this question is 12-18 months, I have seen good results last for well over a couple of years.

Why don’t some other clinics offer dermal filler tear trough treatment?

Treating under the eyes requires a high degree of experience and skill.

The tissues here are very fine and unforgiving, and it is easy for an inexperience injector to make an error of judgement.

In addition the whole face needs to be assessed by an experienced injector.

Often a subtle strengthening and enhancing of the cheek under the eyelid is required to give support to the tear trough and under eye region, rather than treatment solely to the tear trough.

Not all temporary dermal fillers are ideal for the tear trough and under the eye – some are too prone to causing fluid retention and long term swelling – and some clinics do not stock the ideal products for this region.

What can go wrong with dermal fillers under the eyes?

When performed correctly these treatments are very safe and effective.

However problems can occur, particularly in inexperienced hands.

TOO MUCH FILLER USED

This is probably the most common issue I see in patients treated elsewhere.

This is a tricky area to treat, and the natural tendency of the inexperienced injector is to try and get a near perfect result.

Unfortunately this often means that too much filler is used which causes swelling or an unnatural appearance.

I always tell my patients that I am NOT trying to get perfection, I am only trying to get a good improvement.

If you look at the before and after picture here you will see that the result is not perfect, but I discussed this with the patient and together we decided that it was certainly “good enough” and not worth the risk of trying to improve further.

Dr Christopher Leat – Medical Director Envisage Skin Clinic Founder and Director.

Dr Christopher Leat has 33 years’ experience in Medicine and is a member of The Royal College of Physicians of London. Dr Leat has devoted the last 18 years to Cosmetic Medicine and is recognised throughout Australia as one of the most experienced doctors in the field of Cosmetic Medicine.