The eyes – Analysis by Dr Gauthier – Part IV

Analysis of the Eyes – UNDER-EYE CIRCLES

“The eyes are the greatest weapon of coquetry…” wrote Stendhal.

And this is true for everyone at any age!
I will remind you that the eyes are an indivisible whole enclosed in a “frame”

• Eyelids,
• Forehead,
• Temples,
• Under-eye circles
• Eyebrows

It is on this “frame” that we can act.

In the first part I treated the eyelids. In the second part I treated the forehead. In the third part I treated the temples.

I will now speak about the UNDER-EYE CIRCLES.

Under-eye circles are a very common complaint. They can appear very early on, from around the age of twenty.

Under-eye circles have the following characteristics:

• a more or less large hollow (or depression),
• a more or less dark colour,
• extension into the cheek known as the “tear trough”.

1 – The depression:

Treatment consists of restoring volume to diminish the depression if it is considerable or hollow looking.

There are two possible methods:

• A medical method through hyaluronic acid injections. The treatment of under-eye circles requires a specific technique and type of hyaluronic acid.

In fact, to avoid the undesirable side effect of slightly bluish bags, it is necessary to use a product which is specially adapted to this fragile area (where the skin is extremely thin), and to administer the injections very deeply, touching the bone.

With the right technique, the right product and, above all, an exact calculation of the volume to be restored (that is, with a conscientious and skilful doctor), the results are immediately visible.

In this area, the results generally last for 2-3 years.

• A surgical method using lipofilling is also possible. As with any other area, lipofilling permanently restores volume, unlike hyaluronic acid.

2 – Colouration:

In the case of coloured under-eye circles, a filler treatment is still possible and could partly improve the problem.

However, in the case of dyschromia (skin pigmentation disorder), a surface treatment will be necessary. In this case, two types of pigmentation treatment are possible:

• Laser treatment (CO2, Erbium) can be carried out,
• A depigmentation peel treatment could improve the colour of the circles. This treatment was initially used to treat dark circles in patients with black skin, however it can also be used on patients with white skin. The only rule to follow concerns exposure to sunlight, which must be totally avoided for the duration of the treatment and the following 15 days, in order to avoid pigmentary changes.

Light-based treatments (flash lamp, also called Intense Pulsed Light) are often ineffective.

3 – The tear trough:

The tear trough is made up of the extension of the under-eye circle. It often makes a diagonal hollow mark on the cheek and gives a tired look to the eyes and the face, whilst accentuating the nasolabial folds.

Treatment of the tear trough must always precede eventual treatment of the nasolabial folds, because injection into the tear trough will restore the harmony of the face, revitalise the expression and, through a “mini lift” effect, improve the nasolabial folds.

Restoring the volume of the tear trough must be done very carefully in order to ensure the cheeks are not disproportionately large when the patient smiles.

It is carried out using hyaluronic acid injections.

The injections can complete a filler treatment of the under-eye circles by being extended towards the tear trough. On the other hand, the hyaluronic acid used will not, generally, be the same, because the tear trough requires a more volumizing type of acid (whilst ensuring that it is not “too” volumizing…).

The rediscovered radiance of the lower eyelids will help give your eyes – your “greatest weapon” – their full power of seduction.