People say the eyes don’t age, but unfortunately for the skin underneath the eyes, it’s a different story. The under-eye area can lose volume, become hollow and the skin can become thinner as we get older, making the face appear drawn, tired and gaunt. As well as this, some will develop bags and discolouration under the eye too, adding to the aged appearance.
Here, Dr Martyn King, GMC registered doctor, internationally accredited and award-winning aesthetics expert, ACE Medical Director and Vice Chair of the JCCP and a specialist in the ‘tear trough’ treatment offers his advice for rejuvenating the under-eye area and maintaining a youthful look.
“At my own clinic, my area of speciality is the tear trough treatment and since the last lockdown, it has become even more popular due to the amount of people using Zoom and Teams for meetings. The tear trough becomes more pronounced with ageing, although it can also be genetic meaning younger patients are also seeking treatment.
“The majority of dermal filler treatments focus on the midface and the cheeks, but even when doing these areas, I would normally inject a small amount of filler in the tear trough as well as it greatly enhances results.
“It is one of the areas that a lot of practitioners won’t treat because it is a less forgiving area and poses a higher risk in terms of complications. It’s definitely an area where less is more – you don’t actually need a lot of filler to make a big difference here.
“Many people suffer from loss of volume in the under-eye area, but no-one naturally has bulging in this area so if it is over-treated, the face can look odd and out of balance.
“When we look at people, the first place we are drawn to is their eyes, and if they are slightly hollow it can make them look more tired and drawn, so just filling in the tear trough makes individuals look more awake, fresher and more youthful.”
What complications can you get?
“It’s a high-risk area for bruising. It’s also an area prone to what we call Tyndall’s Effect. This is where filler is injected too superficially and gives the skin a bluish hue. It happens a lot with tear trough treatments because the skin is thinner there.
“It is a more high-risk area for lumps, because again, the skin is thinner skin and there is narrower space to inject into – you don’t really have much in the way of a fat compartment under the eyes. One of the other complications is malar oedema, or under eye swelling, and it is important to ask if the patient is prone to under eye swelling before proceeding with treatment.
“However, the risks of complications are very low if you use quality products such as UTH dermal filler, and always go with a medically trained practitioner.
How do you manage complications in this area of the face?
“The main thing is prevention, so there are a lot of steps I would take when I’m treating this area to minimise that risk. Being happy with the product you’re using is key, you certainly wouldn’t want to use any substandard products near the eye area so more so than ever, every patient needs to ask the practitioner what product they are using and why.
“You need to think about the type of filler too. I would tend to go for UTH Deep, from the UTH Aesthetics range in that area. You don’t want anything that’s too rigid, but you need something that’s going to lift the area.
“Finally, the practitioner needs to decide whether to use a needle or cannula, whether to aspirate, and I advocate applying digital pressure to the side of the nose when injecting to lessen the risk of intravascular dissemination of filler.”
Martyn continued: “In the rare case of a complication, and depending on what the complication is, the filler may need to be dissolved which is why it is important to use a hyaluronic acid filler in this area.
“What I would say is that from an aesthetics point of view, treating this area makes more difference than anywhere else on the face to giving you a younger, fresher appearance.”