Filler injection

How To Treat Dark Eye Circles With Filler





I would like to introduce our next model, Brandy, who was treated by me a couple of weeks ago to have treatment to her tear trough, nose, chin, and lip, but this was done off-camera. However, you can see that despite treating the tear trough she still has some degree of hollowing, especially when I get her to tilt her head down and gaze upwards. Accordingly, I would like to give her a little bit more treatment today to the tear trough just to see if we can improve the appearance of the dark eye circles. You can see that as she is young, this is a congenital issue for her.


Tear trough injection marking


Let’s now review the markings for Brandy’s tear trough treatment. The very faint white line I am pointing out here is the orbital rim, and the black dotted area is the lid-cheek junction. Accordingly, I want to place my product above the black dotted line but below the orbital rim.


Tear trough treatment


To treat Brandy’s tear troughs, I am going to be using a 27 gauge soft tissue cannula, so I use a 25 gauge needle to make the entry hole. I am pinching the skin and holding my cannula like a pen, and I want to ensure that I reach a deep level along the periosteum. Once I am happy with my depth, I can then adjust my grip. You will notice I use the fingers of my non-injecting hand to constantly let me know where the tip of my cannula is. This is particularly important in the medial section. I am using a very small amount of product, perhaps 0.01 ml microboluses fanning out over a very wide area, and this is why using the cannula is particularly useful. It is vital when injecting the tear trough region not to over inject the product, otherwise you may get swelling and visible appearance of the product. After I have injected in the deep plane, I want to then adjust my cannula so I am injecting more superficially, particularly when I am injecting in the medialmost part of the tear trough. This is because the ligament in this area is very tightly adhered to bone and it is not possible to get below it, so we have to inject in the muscle. You can see from this angle how I am injecting very superficially. Let’s remove the markings and see what degree of improvement this has given us. We can see following treatment to her right side we already have considerable improvement of the eye bag and infraorbital groove compared to the untreated side.




I now have Brandy following treatment to both sides, and we can see immediately that there has been a significant improvement in the appearance of the under eye hollows. On her left side, there is still a subtle groove visible, but it is important not to treat to correction as we may end up over treating this area and getting a lumpy appearance. If we compare her to her pre-treatment photo, we can see that the result that we have obtained is significant, and this is a good place to stop the treatment. Although we don’t have footage of Brandy’s original tear trough, nose, lip, and chin treatment, for educational purposes I thought it would be interesting to review her result. If we see her here in frontal view, you will be aware that although she has the same coverage of makeup in both photos, by improving the contour below her eye we can see how much better the makeup is able to disguise the infraorbital hollows. We can also see the impact of giving her a more elongated chin shape, and more structure to the lip. Finally, notice how treating the nose makes it appear more narrow in the frontal view. Now, let’s have a look at her in the side profile. In these photos you will appreciate the high impact the treatment had on her profile. You can see that the dorsal hump gave her an impression of having nasal dominance. This was also exacerbated by the fact that she had thin lips and a slightly retruded chin. By balancing the chin and the lips, and also by treating the dorsal hump, we can see that the side profile is more pleasing. Finally, by treating the anterior cheek we have managed to eradicate the negative vector from the eye down to the anterior cheek, so all in all she has a much better profile following her treatment.