While more and more patients are seeking complete Facial Sculpting treatments, men and women alike are specifically looking for improvements to their Under Eye Hollows and Dark Circles. Although their occurrence is quite common and natural with the aging process (more so in patients with darker skin types), dark circles and under eye hollows can make us appear older, more tired, and less approachable.
At Emerage Medical, board-certified dermatologist Dr. Jason Emer, a renowned specialist in facial rejuvenation and non-invasive anti-aging treatments, uses injectable fillers (in combination with other non-surgical methods such as lasers, peels, mesotherapy, and microneedling with PRP, also known as the “Vampire” Facial) to improve under eye hollows and dark circles. Injectable fillers are a quick, cost-efficient, and less invasive cosmetic treatment option as opposed to a surgical blepharoplasty (eyelid skin removal or eyelid bag reduction) that can still give softening and fill with overall enhancement in various areas of the face such as the undereyes. Precision injecting with a true expert like Dr. Jason Emer can provide natural, subtle results that give you a brighter, friendlier, less tired, and more youthful appearance overall.
What causes under eye hollows and dark circles?
As we age, our skin naturally starts to sag (particularly in the most expressive areas of our face), and we begin to lose volume in the midface and cheeks. As a result, the under eye area becomes hollow, giving the impression of “raccoon eyes.” To create visible improvement with injectable fillers, Dr. Emer subtly lifts, shapes, and contours the cheeks or middle face sagging and then addresses the tear trough area directly. It is important that the placement of the filler product is even and complete throughout the cheek and under the eye to ensure a natural lift and fullness without an “overly done” or “swollen” look.
How does it work?
First, a thicker, more viscous filler is used to lift the middle cheek fat pads that provide support to the under eye. For this, Dr. Emer might use products such as:
- Juvederm Voluma or Juvederm Vollure, the most commonly used hyaluronic acid-based fillers for this area
- Restylane Defyne, a hyaluronic acid dermal filler primarily intended to elevate and smooth deep nasolabial folds and marionette lines
- Radiesse, a calcium-based filler comprised of calcium hydroxylapatite microspheres that promotes collagen production and provides an immediate lift and volumization
For those seeking long-term improvement, Dr. Emer uses Bellafill, a semi-permanent injectable filler that binds to the skin tissue and creates a scaffold beneath the skin, promoting natural collagen production.
Next, a softer, thinner filler is injected superficially to fill out the fine lines and plump the tear trough area. Using a blunt-tipped cannula (and a needle for fine-tuning), Dr. Emer is able to limit pain, bleeding, swelling, and downtime. To soften out the under eye area, Dr. Emer uses a combination of:
- Restylane Refyne, the softest filler in the Restylane product family. Made from hyaluronic acid (HA), a substance that occurs naturally in the human body, Restylane Refyne is often used to soften fine lines, neck lines, soft folds, the chin crease, and under the eyes. With a consistency of honey, Refyne sticks to the surrounding tissue, so it moves easily with your skin and rarely lumps or clumps. Refyne typically lasts for 6 to 9 months.
- Restylane Silk, a soft, HA-based filler specifically designed for and FDA-approved to treat the lips and wrinkles around the mouth. Restylane Silk also offers subtle, natural-looking results in the under eye area. Injections typically last 6 to 9 months and can be combined with lasers for optimal improvement.
- Belotero Balance, an HA-based injectable filler specifically designed to treat moderate-to-severe lines and wrinkles above and around the lips. The smoothest and softest filler on the market, Belotero Balance integrates completely into the tissue (so there is minimal risk of lumps or bumps beneath the skin), improves skin texture long-term through enhanced collagen production, and is the go-to filler for patients who are looking for the most natural look. The results of Belotero Balance typically last 6 to 12 months.
- Juvederm Volbella, a soft filler ideal for subtle improvements in shape, lift, and definition. In addition to the under eye area, Juvederm Volbella is often used to fine-tune the lip corners and lip lines, reduce neck lines, and contour the nose. Dr. Emer injects Juvederm Volbella in microdroplets and lightly massages the filler into the treated area. Patients see immediate improvement after just a single treatment, and in most cases, the results last up to 12 months.
How does Dr. Emer do it differently?
To complement under eye fillers, Dr. Jason Emer uses state-of-the-art laser resurfacing devices, microneedling radiofrequency, as well as specialized skin care products and peels to produce significant improvement with dark circles and under eye hollows.
- Dr. Emer uses the Aerolase LightPod Neo (above), a powerful microsecond YAG laser, to deeply heat the skin beneath and around the eye, which improves circulation in the area and reduces vascularity and pigmentation.
- Through skin resurfacing treatments with the ablative CO2 laser (above), Dr. Emer uses controlled energy to heat numerous layers of the skin and ultimately produces tighter, smoother, and less wrinkled skin. Because this is a more aggressive treatment, patients can expect the skin to peel for 3 to 7 days.
- Dr. Emer also uses Cosmelan and Enlighten Peels (available for purchase on ShopEmerMD.com) as part of his non-surgical combination approach
. The gold standard leave-on peel, Cosmelan targets pigmentation by inhibiting tyrosinase (an enzyme in the melanin formation process) and accelerates cellular turnover to remove dead skin cells, lift pigment, soften texture, smooth the skin, and reduce pores and fine lines.
- Microneedling with platelet-rich plasma (PRP) can also help improve wrinkles, fine lines, and mild skin laxity in the under eye area.
- Following your treatment, Dr. Emer and his in-house skin care specialists will craft a customized skin care protocol that will brighten, strengthen, and hydrate the delicate skin around your eyes and further improve the results of your treatment. Dr. Emer often recommends a combination of:
- RestorSea Pro Firming Eye Serum, a fast-absorbing serum that stimulates circulation, tightens the under eye area, and helps reduce the appearance of under eye puffiness and dark circles
- Sente Illumine Eye Cream, which is clinically proven to diminish dark circles, lines, wrinkles and puffiness around the eye area
How long do improvements last?
Duration of improvement varies depending on the type and brand of filler used and how each patient’s body responds to the treatment. It’s important to keep in mind that improving under eye hollows and dark circles is not a one-time treatment; long-term improvement requires continued maintenance with peels and lasers along with a daily at-home skin care regimen.
Are there any risks involved?
The under eye area has a high vascular network comprised of many tiny blood vessels, so there is a significant risk of bruising and swelling if fillers are not injected properly. There is also a risk of blindness due to the treatment area’s proximity to the eye. Please see an experienced, board-certified dermatologist like Dr. Emer to ensure that fillers are administered properly, subtly, and with the utmost precision.
What is the downtime?
While some patients may experience minimal bruising and swelling, there is typically little to no downtime for under eye treatments with injectable fillers. Patients can return to work, the gym, or their everyday activities immediately following treatment, although it is recommended to take 24-72 hours off to ensure the products settle evenly. All fillers require 2 weeks before seeing the final outcome, and an assessment can then be made to determine if more product or additional treatments are needed for even more impactful results.
Am I a good candidate?
To determine if you are an ideal candidate for under eye fillers, please schedule a consultation with non-surgical skin rejuvenation specialist Dr. Jason Emer. After a formal evaluation, Dr. Emer and his team of experts can develop a personalized treatment plan best suited for you to obtain your desired improvements.
For patients with under eye bags that cannot be improved through non-surgical treatments alone, Dr. Emer may suggest a Lower Blepharoplasty surgery (performed by Dr. Emer and his expert surgical team), which safely removes the fat pockets beneath the eye.
How do I schedule a consultation with Dr. Emer?
To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge to schedule an appointment. Call 424-800-4140 or email us at [email protected]