Eye Circles

Hollows. BAGS. Puffiness. Dark shadows. Circles.

-Dr. Liz Kelleher, drliz@lkaesthetics.com, (021) 484-3444


The skin of the eye area is very sensitive and fragile, easily revealing the signs of fatigue or age. Eye circles appear first at the corner of the eye and then spread on the contour which makes the eyes sad and tired. The circles can have different origins: fatigue, deficient microcirculation, unhealthy lifestyle, and they are often hereditary. They are a common concern for men and women. From the age of 30 more than 50% of women are concerned by eye circles (from an Arcane study done in France in Feb 2011 on 4402 women).


As we age, there are gradual changes taking place in our faces and especially around our eyes. The changes happen in all the layers of the face, including skin, fat, muscle, and bone. In youth, due to the surrounding plump fat, thicker overlying skin and soft tissue surrounding this structure, this ligament is usually invisible. Firstly the delicate skin around the eyes is vulnerable to sun damage and can develop fine lines and wrinkles and become “crepey” in texture. There is a natural slow decrease in fatty tissue under the lower eyelid and upper cheek area.  The muscles of the lower lid slowly lose elasticity and no longer remain tightly tethered in place. Also the cheekbone and eye socket shapes are slowly receding over time to result in a lack of bony support for the skin. The rates that these changes happen vary a lot in different people, and are also linked to smoking, stress, skincare, sun exposure, body weight, and genetics. These changes can eventually cause the tear trough depression to become puffy or bulge away from the face (pseudo herniation of the infraorbital fat pads).  When the tissue under the eye pushes outward, ‘bags’ begin to develop.  The unevenness of the area can become shadowy, which in turn will look like ‘dark circles’ under the eyes.  No matter how much makeup is worn, the face can still looked exhausted and drawn. 


Using tiny injections of hyaluronic acid injectable gel specially designed to treat the delicate and sensitive eye circle area, a significant improvement for tear troughs can be achieved.  Hyaluronic acid is a molecule naturally present in the dermis giving hydration, elasticity and firmness to the skin. The gel will gently fill the tear trough depression, making it look smoother and healthier.  With the area no longer sunken, the dark ‘circles’ are reduced, as the thin skin in this area is highly reflective and shadowing is reduced when the hollowness is corrected with fillers.  Best of all, the results from this treatment will be immediate.  

This treatment is not suitable for pigmented dark circles neither for large malar and palpebral bags, those last ones being better suited to surgery.


Men and women with eye circles, especially in patients in their late 30’s to 40’s, to essentially fill out the trough. Commonly in this age group, the loss of volume at the junction between the upper cheek and lower eyelid, i.e. a worsening tear trough deformity, is the only obvious sign of ageing. Therefore simple replacement of this lost volume without the need for surgery can lead to dramatic improvement.While tear troughs normally appear in the 30s or 40s, people as young as 20 may begin to notice this early sign of aging. 

The ideal candidate for tear trough correction is anyone who understands the procedure, is in generally good health, and holds realistic expectations for their results.  


After 9 years of research and clinical trials, Teoxane Laboratories in Geneva introduced a brand new product to the aesthetic medicine market, specifically developed to treat the difficult and sensitive area around the eyes. Redensity II [eye] is an injectable gel specifically adapted to treat the undereye hollows and tear trough. It is a fully transparent viscoelastic gel and just slightly hygroscopic (i.e. it attracts very little water resulting in minimal or no swelling after injection). The viscoelasticity is perfectly designed to coat the undereye hollows safely and durably and assures an easily spreading and controlled positioning of the gel.

Can other dermal fillers be used to treat them? Yes – but not as well, and not for as long. Other fillers are much more likely to migrate with time towards the inner part of the tear trough leading to the appearance of a lump. Teosyal Redensity II doesn’t form lumps.

Teosyal Redensity II is the ONLY Aesthetic injectables product in the UK licensed for the treatment of tear troughs.


What’s involved in treatment? The treatment involves 3 or 4 injections under each eye. The formulation of Teosyal Redensity II includes lidocaine, an anaesthetic ensuring optimal comfort throughout the injection session. We also use an ice pack to keep the swelling to a minimum. It takes around 5 minutes to complete each treatment.

There may be some discomfort during treatment, either when the injection takes place or during the massage that ensures a smooth contour, although many patients find it relatively pain-free.
Occasional contour irregularities can occur but, once any swelling has subsided, you can massage any tiny lumps with your thumb or index finger to flatten out any unevenness.

There may be some bruising and/or mild swelling but these normally disappear in around a week.


Teosyal's Redensity II [eye] is a second generation dermal filler which has been exclusively formulated for the undereye area. Significant side effects are extremely uncommon but may include:

• Injection-related reactions: These reactions may include redness at the injection site immediately after the treatment.

• Bruising: Occasionally bruising can occur. 

• Contour irregularities can and do occasionally occur. Massaging can usually smooth out any 'lumpiness' however if persisent the filler can be easily and rapidly dissolved.

• Infection - as with all injections, this procedure carries a risk of infection. The syringe is sterile and standard precautions associated with injectable materials are taken.

• Swelling - unlike the use of generic dermal fillers for tear trough treatment, the use of Redensity II [eyes] results in only very minimal or no swelling at all.


The results with Redensity II [eyes] are visible immediately and typically last on average 12 months (clinical evaluation on 67 clients followed up after 1 ear) although the exact length of time will depend on the structure of your skin and other factors such as lifestyle, age and the degree of perfection demanded by you. Additional touch up treatments can be performed at any time after the initial treatment.


We charge €450 for 1ml of Redensity II (Eyes). Although 1ml is the recommended dose by the manufacturer, more is sometimes given during a second procedure, best carried out at least one week after the initial treatment. Around 25% of patients seem to choose to get a 2nd ml of this product. If this second treatment is given within 1 month of the 1st, a reduced price of €350 will be charged for the second syringe.


If you are unhappy with the result, the filler can be easily and rapidly dissolved with an injection of hyaluronidase.

Contact us at (021) 484-3444 or driz@lkaesthetics.com to book a free consultation.

Further Reading

Dermal Fillers for the Treatment of Tear Trough Deformity: A Review of Anatomy, Treatment Techniques, and their Outcomes