The sunken dark circle is a very common reason for consultation. Often constitutional, it is found even in adolescents. With age, bone, muscle (orbicularis of the eyelids), dermal changes and melting of the fat under orbicular can create dark circles or accentuate it.
THERE ARE THREE TYPES
Hollow dark circle
Fatty melting or its genetic absence is responsible for a hollow.
Dark brown circles
Caused by a pigment deposit (melanin), often hereditary.
Blue or red circles
Caused by the visibility of the capillary vessels of the dermis which appear by transparency under an extremely fine skin. It is hereditary or related to age.
STAGES OF GRAVITY
Absence of dark circles
Very deep dark circles
Light dark circles
Moderate dark circles
Deep dark circles
Hyaluronic acid removes the hollow ring/ dark cricle and improves the blue and the dark. The ring is a delicate indication and it is recommended to choose a very experienced doctor trained in the technique. This is a difficult indication because:
- You must inject at the right depth and have a perfect knowledge of the anatomy of this area. The product must be injected between the orbicularis of the eyelids and the bone, so the injection is deep.
- Do not overcorrect, it is better to inject in two or more sessions.
- It is better to inject the acid via the cannula. Injection into the cannula avoids any vascular complication (this anatomical area is highly vascularized, the risk of complication is important) The patient is injected only once instead of various times, (needle injection requires multiple stings). Depending on the stage of the ring, we will inject all or part of the sub-ocular hollow triangle.
-The Doctor must inject the right product. The hyaluronic acid used must be slightly hydrophilic so as to avoid any secondary edema. For that I use the Restylane range whose hyaluronic acids are among the least hydrophilic on the market. Depending on the digging of the ring and facial physiognomy, I inject a hyaluronic acid moderately reticulated type Restylane or very reticulate type Restylane Perlane. The failures exist in case of technical fault, one can have over-corrections, a bluish effect (it is the Tyndall effect, due to the superficial placement of the hyaluronic acid), persistent irregularities of surface type hump, a permanent edema (swollen eyelids). But rest assured, in the hands of your experienced doctor, such inconvenience is extremely rare.
The reference treatment for dark circles is carboxytherapy one session per month for 4 to 6 months. The injection of CO2 is made intradermally by practicing 4 or 5 injections following a circular arc along the orbital frame. Note: we have a very impressive swelling of the eyelid that lasts only a few minutes. The vascular ring (blue) can be improved by carboxytherapy.
Laser erbium or CO2
This type of laser can be used for dark and blue circles. We perform 4 sessions. It is utilized in the case of older individuals given that with passage of time they loose the thickness of skin, the thinning of the lower eye lid results in visibility of the dermal vascular network. By thickening the skin with this laser, the vessels will be less visible. For dark circles it is used to create micro-ablation wells that promote the removal of pigment and penetration of prescribed depigmenting creams and stimulate dermal synthesis. A thicker dermis reduces the dark color of the ring.
Vascular laser is theoretically a good treatment for the red component of dark circles. In practice we can not treat the whole area because of the proximity of the eye and the result does not last long.
Laser pigmentation removal
The Qswitched laser is used in very specific indications by an experienced practitioner. The sequels are marked by significant swelling of the lower eyelid for two days. One session is sufficient.
BEFORE AND AFTER PICTURES