At Castleknock Cosmetic Clinic Dublin we use dermal fillers under the eyes area to help with the problem of prominent tear trough. In the process we try to fill in the depressed curve that forms between the cheek and the lower eyelid, an area called the tear trough. In the process I may also build up the cheek to help smooth the area between the tear trough and the cheek. The goal is to fill the tear trough below the eyelid and lift the cheek to provide a more natural support and contour between the two, effectively masking the appearance of sunken eye.

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 Lyft, Radiesse, and Juvéderm Voluma 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 Skinbooster, Belotero Soft and Juvéderm Volbella 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 retrograde with a cannula, a technique successful with deep seated of the dermal fillers. This tear trough treatment approach 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 tunnelling 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 convex 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.

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