At Castleknock Cosmetic Clinic Dublin we use dermal fillers under the eyes to help with the problem of bags is typically trying to fill in the depressed curve that forms between the cheek and the bag. I also build up the cheek to help smooth the area between the bag and cheek. The goal is to fill the tear trough below the bag and lift the cheek to provide a more natural support and contour between the two, effectively masking the appearance of the bag.
In the sandwich technique used in the SoftLift, an advanced mix of dermal fillers is placed above the periosteum (deeper than some other facial areas) from the cheek to the infraorbital rim (the bone below the eye socket). Restylane Sub-Q, Radiesse, and Juvéderm Volume can be effective fillers in this area because it can provide the necessary bulk and then assists in bulk lifting the area. Lighter dermal fillers like Restylane Touch, Teosyal Global and Juvéderm 2 are placed in the superficial area giving a soft feel and natural texture.
In most facial areas, dermal fillers are placed with what are known as threading or tunnelling injection methods. In the cheek area, some I prefer a coning cannula technique with some of the dermal fillers. This method places the dermal filler perpendicular to the delicate area around the eyes, placing it deep so that the cones of fillers push up on the skin. As with the tunneling technique, the dermal fillers are not visible underneath the skin.
Sunken eyes and dark circles are treated much the same as bags are treated. The goal is to fill in the cheek and part of the deficit under the infraorbital rim, which can provide a shapelier contour and in many instances nearly eliminate the hollow, gaunt appearance.
Various theories are propounded about the cause of dark circles. Some literature points to vascular issues. Some say it is a light refraction issue caused by either bulging bags or sunken hollows. In any event, the dermal filler procedures mentioned in the section above will have some effect on dark circles below the eyes and in the tear trough. Some patients report astonishing knocking back the year’s results.