Monday, 28 September 2009

Dark Circles Causes & Treatments (Part 2) - Hollow Eyes

Continuing from our previous article we will discuss the texture changes that can be responsible for dark circles and ways to combat them.

Hollow Eyes
Hollowing under the eyes creates the so called exposed ‘tear trophs’ or ‘tear ducts’ which is a groove running from the inside corner of the eye to the lower part of the eyelid and quite often into the cheek.

This is usually related to the normal ageing process. We loose approximately 5 ml of fat from our face every year and this fat loss is what is to blame for the appearance of deep folds and sagging in the skin as well as hollowing of the cheeks and eyes.

The human face can be likened to a balloon which is well inflated when we are young and our faces are full of “puppy fat” and gradually deflates with age as we loose fat. This process can be greatly accelerated by a rapid weight loss following yo-yo dieting. The skin is often unable to adapt to the rapid change of volume and sags as opposed to recoiling back into the new shape and can lead to premature ageing and increased wrinkles. In younger individuals and also in males, where the skin is thicker and more elastic yo-yo dieting is less risky. However women over 30 yrs should be careful and plan any weight loss over a longer period of time in order to avoid this problem.

Hollow eyes can also be hereditary in which case they are apparent from a very early age (usually 20 -25 yrs). We ask patients to bring photographs of themselves when they were younger and also pictures of their parents. This is useful to determine hereditary factors.

One important cause of premature eye hollowing is following surgery to the lower eye lid (lower blepharoplasty). When the problem is lower eyelid bags many patients resort to surgery which can be effective way of removing the bags. ‘Eye-bags’ are due to protruding fat and therefore removing some fat usually brings an immediate good result. However in the long term this lack of fat together with the natural ageing process can speed up the appearance of hollowing around the eye. There are many techniques for operating on the lower eyelid and some of the older methods involved removing too much fat. Modern techniques used in today’s surgery are more sparing towards the eyelid fat and involve repositioning of the fat rather than removal.

The best treatment for correcting hollow eyes is by using a non-permanent dermal filler. My choice when it comes to dermal fillers is stabilised hyaluronic acid. The advantage of using this type product is that the effects can be fully reversed even earlier than the natural absorption of the product, which can be reassuring to the patient.

The dermal filler is placed deep over the bone in order to fill in the groove. The procedure is almost painless and rarely requires an anaesthetic. The success rate is very high ( 80 -90%) and the results can last for over a year. It can however be a dangerous procedure in un-experienced practitioner as it can quickly turn the hollow eyes into baggy eyes if the product is placed incorrectly i.e. too superficial. For this reason always seek out an experianced cosmetician and go ensure you are completely happy with everything discussed with you. If you have any questions, you should always ask them.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and what treatments are avialble to combat them, so keep an eye out for Part 3!

by Lucy Glancey

For more information on dark circles, treatments and dermal fillers, visit

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