Cosmetic Clinics

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

Eye Bags
Eye-bags are due to herniation (protrusion ) of fat in the lower eyelid which in some cases can be hereditary and can be visible from a very early age. Usually it is a result of the normal aging process when the skin looses its elasticity and allows the fat to protrude and become more visible. There are two types of eye bags, true eye bags which are due to genuine fat protrusion and pseudo eye bags which are caused by severe eye hollowing creating an impression of a “bulge”. Quite often there are both types present in the same individual to varying degrees.

Treatment
This will be dependent on the type of eye bag. True eye bags require surgery (lower blepharoplasty) while pseudo bags will require a dermal filler as described above. When there is a combination of both types, surgery will be required, followed by dermal fillers once the healing process is completed.

Wrinkles
Fine wrinkles under the eyes create a different texture and when excessive can give the appearance of dark circles. This condition is age related and the process is greatly accelerated when there is a degree of sun damage. The lower eyelid skin is very thin and therefore this is an area where wrinkles to appear first. In some individuals this can be exaggerated by the lack of natural bony structure therefore people with higher cheek bones have less wrinkles under the eyes.

Treatment
Wrinkles can be difficult to cover with make up as it tends to settle in the wrinkles making them more obvious. Prevention of sun damage is important especially in the delicate skin around the eyes, so the use of sun block is even more important than eye creams. There are certain eye creams that contain sufficient amounts of active ingredients (e.g. Retinoids) and are effective in preventing, and even reversing sun damage and consequently wrinkles. The most potent creams are available only on doctor’s prescription. Wearing good sunglasses in the sun can also be a good preventative measure.

In a younger patient (35 -40 yrs) a low dose of Botulinum Toxin type A (Botox or Dysport) can be effective, however this can result in discreet widening of the eye which may change the eye shape. It is important that the Botox procedure is performed by a well trained practitioner as an incorrect placement of this product in the lower eye lid can result in severe consequences leading to ulceration of the eye.

Chemical peels and laser resurfacing can work but are associated with higher risks of delayed healing, hyper and hypo pigmentation. The downtime for these procedures can be lengthy and can be a traumatic experience for the patient. Intense pulse light (IPL) can be used in the form of photorejuvenation ( photofacial) but requires several sessions and the results can often be modest.

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 4!

by Lucy Glancey

For more information on dark circles and treatments including dermal fillers, Botox and chemical peels visit www.cosmeticclinics.co.uk

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.

Treatment
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 www.cosmeticclinics.co.uk

Dark circles under the eyes together with cellulite are probably the most commonly talked about aesthetic imperfection. This is partly due to the fact that there is very little one can do to completely eliminate either of them. For both conditions a variety of over the counter creams are sold that promise the world but deliver less than modest results, as many of us who have tried them can confirm. However in the treatment of dark circles new advances in cosmetic medicine, such as laser surgery and dermal fillers, the condition can be improved up to 80 – 90 % (depending on the reason for the dark circles) which is good news for those who have been long suffering.

What are dark circles?
This is the appearance of different colour, texture or a mixture of both on the lower eyelid area. It is far more difficult to treat the so called complex circles where there is a combination of colour difference and textural changes. In our clinic we use grading system for patients with dark circles. There are 4 grades;

Grade 1 – these are very mild and only visible without any make up. They disappear totally when make up or concealer is applied.

Grade 2 – these are visible even with make-up but of moderate severity. A good way to demonstrate grades 1 and 2 better and especially for the purposes of medical photographs is to ask the patient to put their chin down and look up to the ceiling without moving their head. This is important when we take before and after pictures in order to clearly demonstrate the results of the treatment

Grade 3 – these are severe and give the impression of baggy eyes (the so called false or pseudo – eye bags)

Grade 4 – these are the complex dark circles where there is a combination of not only texture but a colour change as well. They require more treatment sessions compared to the other grades.

Over the next few weeks we will outline the differing reasons or causes for dark cirles under the eyes and wat treatments are avialble to combat them, so keep an eye out for Part 2!

by Lucy Glancey

For more information on dark circles, treatments and dermal fillers, visit www.cosmeticclinics.co.uk