Different types of dark circles in patients

Dark circles are far from unique. There are several types, and they are not treated in the same way.

Hollow circles

These dark circles appear as hollows under the eyes and a valley running down from the root of the nose to the cheekbone. They generally result from a loss of subcutaneous fat, induced by advancing age. The skin of the lower eyelid is very thin, allowing the bony contours of the eye socket to show through.

Dark circles

Dark circles are different from hollow circles. The skin is dark (brown, bluish, purplish…) or even reddish, shades that in all cases accentuate the patient’s tired appearance. The transparent effect is due to the thinness of the eyelid membrane, which makes the underlying blood vessels visible.

Dark circles and puffiness

Dark circles are often associated with puffiness, which further ages the eyes. While puffiness may appear at an early age for congenital or hereditary reasons, it is generally part of the natural aging process. The fatty cushion that protects the eye from the bone walls is less and less held in place by the septum over time, sliding downwards.

The importance of consulting a specialized aesthetic doctor

The eyes are an area of the face that requires special expertise. Not all surgeons and aesthetic physicians are specialists. Some will offer you hyaluronic acid injections to fill hollow dark circles, a technique I strongly advise my patients against. In fact, hyaluronic acid, although natural, is a substance that absorbs very poorly in dark circles. Injected into this area, it can end up swelling, absorbing water like a sponge and forming an unsightly pocket, or giving a bluish color to the lower eyelid.

I’m confronted with this problem on a daily basis. Patients come to me with bags under their eyes that are actually the result of old hyaluronic acid injections. The best technique for filling hollow circles is lipofilling (micro-lipofilling), or nano-lipofilling in the case of colored circles. I’ll be sure to explain these procedures in detail during a preliminary consultation. In the meantime, here are a few details.

Treating dark circles: several options to consider

The recommended treatment will depend on your dark circles, which is why I will carefully analyze your eyes beforehand to guide you towards the most suitable option.

Injection of fat into the dark circles

Injection of fat into the dark circles, also known as micro-lipostructure, micro-lipofilling or lipofilling, is indicated for filling hollow circles. I will restore volumes that have melted away by transferring fat from your abdomen or knees. The fat is processed (rinsed, cleaned and defibrosed), and then reinjected into the hollowed-out circles using a microcannula.

During this procedure, which takes place in the operating room, the patient is under general anaesthetic or neuroleptanalgesia, depending on his or her wishes. The procedure lasts between 1 and 2 hours, depending on the procedures involved.

Micro-lipofilling is highly effective against hollow dark circles. The results are definitive and 100% natural. The procedure involves the presence of swelling for 8 to 10 days and the need to wait around 3 weeks to see the final effects.

Nano-lipostructure

Nano-lipostructure involves the injection of stem cells and growth factors derived from the patient’s own fat. It can be used to mask dark circles of any kind.

After a local or general anaesthetic, I harvest a small quantity of fat cells from your knee, abdomen or thigh. As with micro-lipostructure, I clean the fat cells to retain only an emulsion rich in stem cells and growth factors.

I then inject the resulting compound into the area to be treated, using micro-cannulas. The cells diffuse and mix naturally with the cells already present. They gradually regenerate the skin, slightly thickening the dermis and eliminating transparency. In addition, I can offer micro-lipofilling if dark circles are also deeper.

The procedure lasts around 1 hour and involves swelling for 5 to 7 days, as well as bruising at the injection sites. Final results are seen after a few months.

Laser pocket removal

Finally, in the case of puffiness associated with dark circles, I treat both indications simultaneously, and propose their removal using a CO2 laser via the transconjunctival route, i.e. through the red part of the eyelid. During this surgical procedure, expertise is essential to ensure that the gestures are precisely measured, without hollowing the eyelid or altering the look of the eyes.

The procedure lasts less than an hour and requires local anesthesia or general anesthesia. The result is immediately visible. Puffiness disappears for good, and there are no visible scars or marks.