As we age, we can lose fat and tissue volume underneath the eye area. This, coupled with the loss of skin elasticity and firmness can create a hollow appearance. Hollows under the eyes can lead to dark circles and shadows, making us look permanently tired.

From his many clinics around the UK from the Midlands to London, Dr Dan Dhunna offers a revolutionary non-surgical solution to tear trough deformities, using specifically-formulated hyaluronic acid (HA) dermal fillers, injected in to precise areas and tissue depth under the eyes. This technique is exceptionally advanced and should only be practiced by an experienced doctor, such as Dr Dan Dhunna who understands the complex anatomy of the tear trough area, which is paramount to achieving successful and natural-looking results.

Before we look at the treatment itself, it’s important to recognise the cause of your under eye circles, as not every case is due to a loss of volume in this area. Lifestyle choices such as smoking, not getting enough sleep, dehydration and stress can all be a cause of dark circles and dermal fillers will not be able to disguise dark circles in this instance.

Anaemia is also linked to dark circles and in these cases, should be investigated and treated by your GP.

Excess skin pigment, most common in Asian, African and darker skin tones can be treated by prescription ‘lightening’ creams and cannot be corrected with dermal fillers.

Visible blood vessels, more commonly seen in light skinned patients are caused when the underlying blue-green vessels are seen beneath the thin skin in the tear trough area. These vessels give off finer, smaller vessels, which constantly leak, leading to chronic low-grade bruising. In this instance, PRP (platelet-rich-plasma) treatments can be more effective to treat dark circles.

Am I suitable for dermal fillers for the tear trough area?

Before we can determine whether your dark circles are caused by loss of volume or indeed, a specific condition, Dr Dan Dhunna will ask that you attend a no obligation consultation, so that he can decide if dermal fillers for your under eye circles will be suitable.

If you have puffy eye bags in this area, you might notice that there is a groove which can be seen within the orbital ring and just below your eye bags. If you are experiencing this, a dermal filler treatment could be an effective solution. However, it may be the case that, before treating your under eyes with dermal fillers, Dr Dan Dhunna may wish to advise some cheek enhancement, again, using filler injections, to create a supportive ‘scaffold’ for the tear trough filler. Failing to create a foundation within the cheek area could mean that a tear trough treatment is not as effective and could encourage migration of product downwards.

If you experience excessively puffy eyes, especially in the morning, dermal fillers may not be the right course of action for your tear trough treatment. This is because HA dermal filler attracts water (around 1000 times its own weight) so if we inject this product in to an area which is already experiencing excess fluid (such as in cases of lymphatic drainage issues) we could exacerbate the puffiness, defeating the goal to make you look less tired and worn out!

However, Dr Dan Dhunna will conduct a full questionnaire, facial assessment and will also check your medical history at your pre-treatment consultation. Once he is satisfied that dermal fillers will be both safe and highly-effective to treat your specific under eye concerns, you can then arrange your appointment for treatment.

Your tear trough treatment

So, the day has arrived for your treatment and you arrive at the clinic. We will firstly ask you to complete some standard consent forms. We will also check to see if there have been any changes to your lifestyle, health or desires for results, since the pre-treatment consultation; to ensure that the treatment is still safe and relevant for you to undertake.

Once the preliminary checks and forms have been completed, you will be made comfortable in one of our treatment rooms. Dr Dan Dhunna will then proceed with the treatment. He may choose to apply some topical anaesthetic to the area where the micro-cannula (a blunt-ended needle, more preferred for this treatment as it glides through skin tissues and past blood vessels, reducing the risk of bruising and discomfort). However, Juvéderm® dermal fillers already contain lidocaine anaesthetic, so a topical anaesthetic is rarely required

The cannula will be guided into the area to be injected, then Dr Dan Dhunna will administer the dermal fillers in precise quantities in to the tear trough groove. Once injected, he may smooth the filler with his fingers for a subtle, natural result. The treatment should take no longer than 30 minutes. After which, you can return to your daily activities with some aftercare instructions given by Dr Dan Dhunna. These include:

• Not rubbing, touching or applying makeup to the area for 24 hours
• Not sleeping on the treated area for 3 days
• Avoiding hot baths, saunas and steam rooms for up to a week, post-treatment
• Avoiding excessive amounts of caffeine, alcohol, Ibuprofen or strenuous exercise for 24 hours

Are there any side-effects with a tear trough dermal filler treatment?

As with any injectable cosmetic treatment, you may experience some slight swelling, redness and a little bruising, following the procedure. This may last a couple of days, but is quite normal and will be lessened by the use of the micro-cannula technique that Dr Dan Dhunna favours.

Using arnica prior and after your treatment as well as treating with a soft ice pack can help with any swelling, minimises bruising and reduces tenderness in this area.

How long will my results last?

Juvéderm® by Allergan is designed to last around 12 months for most patients, depending on their everyday activities, lifestyle and general health. As the undereye area is relatively static and doesn’t move very much, the product may last even longer in this area. Nevertheless, everyone is different in how long their results last and if you take care of your skin, drink plenty of water, eat well and avoid UV rays, smoking and excessive amounts of alcohol, you are maximising the changes of your results potentially lasting for up to 18 months at a time.

Dermal fillers for the tear trough area can offer sublime results for those patients who are prime candidates for the treatment. Dr Dan Dhunna will always advise the most appropriate course of treatment for your specific concerns, so that you can be confident in his sincerity, expertise and ethics when advising you on which procedure will bring you the best results possible.