Guide Health Skin care Treatment

Prominent Eye Circles Tear Trough Fillers


  • The skin becomes lax and dull, sinking without bottom into the soft space immediately below the lower eyelids. Ethos Spa is the best place available for removing of eye circles. The treatment in the spa is perfect to have the desired results. The learning of the reasons and treatment is correct to get more benefits to look beautiful and attractive. Experts are offering services to the people.
  • The thin transparent skin approaches the dark vessels of the eye space, especially prominent in those with allergies affecting the eyes and nose. These dark circles are so prominent, and are referred to commonly as “allergic shiners”.
  • The skin may eventually be stained by hemosiderin which is the purple colored by-product of broken blood cells, especially seen in situations of chronic inflammation or congested blood flow, both seen in chronic allergies of the eyes and nose. This is the late eventuality of a chronic sufferer of allergies.
  • The skin may be stained by brown sun spots, especially along the bony ridge where the cheek bone ends at the eye, effectively emphasizing the outline of the eye circle.
  • Aging, sun damaged skin loses collagen and water with resultant crepe like lines or deeper creases that leaves an increasingly distracting pattern of cross-hatching of the skin, especially in the lower, lateral eye margins.
  • Dehydrated wrinkled skin has an irregular surface that is a poor reflector of light, that is, the skin is dull.
  • Further to light reflection, light passes in a straight line over the indent of the eye circle. Indeed the sunken eye circle is shadowed. This is particularly prominent when vertical overhead lighting streams downward, as in most indoor and outdoor lighting situations.
  • Certain genetic patterns of muscle or bony prominence might contribute to eye circles in youth. In some, the (palpebral) margin of the lower lid (ocularis oculi) muscle along the lower lid margin might be bulgy with dynamic facial expressions.
  • Fat patterning is another consideration, as age and gravity have something to do with the youthful fatty floor of the under eye area eventually dividing under gravitational forces, leaving the top portion bulging upward on the skin, and the lower atrophic portion sliding down onto the cheek, leaving an unsupported base which drops inward like a valley or trough between fatty margins.
  • The atrophic cheek fat pad that slid away under gravity extends along down the same trough line as far as the cheek. This fat pad is shrunken and soft, no longer producing the light reflex it did in youth.


  • The condition is multi-factorial, and so too is the treatment approach multi-modal.
  • The last thing you want to do is emphasize the trough by straight away injecting tear-trough filler which will elevate and illuminate the stained trough. At Nirvana, most of the age related Eye Circles have pigment stained troughs, and therefore these individuals undergo simultaneous Intense Pulsed Light Photo-rejuvenation or Laser Resurfacing immediately following Tear Trough Filler with Restylane. The two procedures are done conveniently on the same visit.
  • There are some skin care products that facilitate success, including pharmaceutical grade topical Vit CE, Retinoid cream, possibly topical vit K eye serum, and regular sun protection.
  • An Intense Pulsed Light Photorejuvenation or Laser Resurfacing Procedure may be done for those with stained troughs. This is usually done immediately after the Tear Trough treatment.
  • A modest amount of Botox to the eye circles might soften the wrinkle patterns, and the prominent eyelid segment of the under eye muscle.


  • Pre-treatment advice includes avoidance of blood thinning medications, vitamins or herbal products.
  • The procedure is not regarded as painful, although needles in the region of the eye may be anxiety provoking. Lidocaine topical anesthetic may be used in advance to reduce discomfort. Almost all will find the procedure easier than initially anticipated. It takes approximately 10 minutes altogether.
  • The choice of product for Tear Trough filler at Nirvana is Restylane, a non-animal stabilized hyaluronic acid product which has the longest reputation of safe use for Tear Trough application. It has been FDA and Health Canada cleared for lines around the mouth, however, the fillers products are all administered in a multitude of zones beyond the initial clearances, quite safely. Restylane was and remains the industry standard for Tear Trough, advocated by leading experts in the field of HA injectables. This is not a procedure that should be done by a novice injector. Dr. Genesis has been injecting to the tear trough since 2005.

  • The benefit is immediate, although the look becomes more natural and soft as the swelling resolves and the substance integrates fully with the local tissues, in days to a week. The change in the look is subtle. People will not likely notice this change, except they might comment generally that you look “rested”.
  • It is rare to have a large bruise in the soft area under the eye, but it is always a possibility. It is more likely in the elderly, and it is not done in those using blood thinning medications. It is common to have a needle bruise which is a quick resolving pin point bleed at the site of needle injection.
  • The treatment is not permanent, as the Hyaluronic Acid has a degradation rate. Most experts quote one year as a typical duration, although experienced injectors will concur that the filler duration is much longer than that in most cases.
  • As the name implies, tiny droplets of Restylane are injected directly onto the bony surface, beneath the under eye muscle layer. The needle is marched along the bony rim of the eye circle, avoiding risky blood vessels and nerves. The blue discoloration that is sometimes observed after some Tear Trough procedures will not occur with proper placement.
  • The Restylane is immobile and trapped between bone and muscle, where degradation is very slow. Gradually the product integrates, molecule to molecule, absorbing water and affiliating with collagen and other tissue matrix molecules, becoming so naturally involved in the formation of tissue matrix that it is believed that HA injections may stimulate a local natural tissue building cascade.
  • If the initial result remains uneven, bumpy, or over-filled there are options. The full integration of the product takes a few weeks, and generally by then the product is “dissolved” in its zone, no longer bumpy. Or, if a quick correction is desired, there is an HA enzyme that will accelerate the dissolution and reformation of the product according to the contours of the compartment. It is a very effective, easy adjunct which takes seconds to administer.
  • There is a very rare risk of droplets of HA entering the retinal artery, sludging the flow of red blood to the retina, possibly causing retinal damage. The estimated rate is 1/10,000 for experienced injectors. This is one of the principle reasons that the HA is injected directly on the bony surface, safe from arterial deposition.
  • Now the under eye skin is elevated onto one plane with the cheeks such that the rays of light reflect off the illuminated firmer surface, a brighter place. In time after the laser resurfacing procedure, the integrity of the skin will further improve as the cascade of remodeling within the skin becomes visible. Wrinkles will resolve, pigment marks are usually completely eliminated, and skin becomes firmer, more reflective, radiant, uniformly colored, smooth textured. The eyes and the cheeks are no longer separated by “eye circles”.
  • The status quo remedy for dark eye circles used to be lower blepharoplasty, “eye surgery”. Now the non-surgical approach is widely accepted as a suitable alternative as safety and efficacy is favorable.
  • The laser resurfacing and Tear Trough Fillers procedures are done at Nirvana as an outpatient, perhaps taking only half hour altogether. Convalescence from the laser resurfacing is quite comfortable at home while performing most activities of daily living.
  • The MD will provide a detailed explanation of the procedure over the desktop, including the detailed sequence of events, pre and post care, expectations, and risks.
Ernestina Chacko is a writer and a photographer. Before joining, she was a senior contributor at Bloomberg USA.