If you think of under eye dark circles, hollowing or bags under the eyes, lines around the eyes and heavy eyelids, you might think that a cosmetic treatment only has one solution for all of these, and that is Botulinum toxin, but not so. Join me as I explore each of the problem areas mentioned and their corresponding selection of solutions.


Undereye pigment.

undereye dark circles

undereye darkness from pigment can happen even in young faces

Many people suffer with pigment underneath the eyes. This is when you have darker skin under the eyes than you have in the rest of the face. Now the undereye area has some of the thinnest skin on the body. The undereyes are also a congested area in terms of blood vessels, so sometimes what you might think is pigment, is not just pigment. Sometimes the undereye problem is actually a combination of pigment, and blood vessels.


The undereye solution:

If you want rid of undereye dark circles (without any hollowing) here are the options

Heavy eyelids

heaviness of the brow usually means there is less space for eye makeup

The eyelids are often heavy for people from birth, but all of us have two problems that occur as we age. The first of these is the tendency for the muscles of the forehead to become generally weaker and drop down by a few millimeters. The second problem is the thinning of the tissues above the brow. While a heavy lid in childhood doesnt look old, a heavy lid with some volume loss or thinning looks saggy and deflated and shows our age.

The solution:

To correct heavy eyelids there are a few different treatments

  • Anti Wrinkle injections to lift the brow
  • Dermal filler to lift the temples and revolumize the brow
  • Emface to strengthen the elevators of the face and improve resting tone

Lines and wrinkles around the eyes

crows feet

Eye with crow’s feet

These lines are known as crows feet. The lines can extend from the side of the eye outwards, can also occur under the eyes and even at the side of the nose. They tend to appear from late 20s and get longer and deeper as life goes on. They are more prominent in men and in people with thinner skin.

The solution

To correct lines around the eyes there are a few different treatments that can help in this area:

  • Anti wrinkle injections with Botulinum toxin for lines around eyes, this can also be used under eyes and on nose
  • Retinol and growth factor serums that can improve skin texture and thickness
  • Microneedling to thicken skin, break the habit of the skin folding in the same place each time and improve texture to get rid of fine lines under eye also
  • Dermal filler can be indicated if there is a loss of volume on the side of the face around the eyes as less tissue means more lines when you smile (why men get more smile lines)

Undereye hollowing

under eye hollows

Under eye hollowing starts in the centre and moves outwards to the side over time

Whether you suffer with a hollowing in the centre of your face under your eyes, or whether it extends all the way around the eye to the side, there are a number of options. Generally hollowing in the center is something that people can have from childhood as a result of face shape and specifically how prominent the infraorbital rim is (the bone just under your eye). People with a less prominent bone here will look tired from childhood. As we age past about 27 most of us start to lose fat at the side of the eye (the first place fat loss derived aging occurs). Undereye hollowing is a slow process and can be the most easy way to identify someones age and also unfortunately to identify bad work.

The undereye solution

The best solution for hollowing of the undereyes is a thorough assessment. How old do your eyes look, is it hollowing at the side or in the centre, is your infraorbital bone recessed? Based on this a treatment can be created using:

  • Retinol under the eyes can be excellent for thickening this skin, when this is thicker we can see less of a hollow
  • Polynucleotides like Ameela can stimulate the undereye area to generate its own collagen and elastin
  • Sunekos and other hyaluronic acids can hydrate the undereye to correct lost volume in this area
  • A dedicated tear trough treatment will make a large difference in a short space of time if there is a deep hollow to be corrected. In time this can wear away and the body’s own collagen and elastin can ‘take up the slack.
  • Cheek filler treatment can often be indicated also expecially as we approach 40 years of age as the tear trough starts to impact the tissues on the cheeks.

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