Why does the practice not perform Skinbooster injections under the eyes ?
Skinboosters are used to improve hydration and reduce certain fine lines. However, their ability to retain water has a disadvantage under the eyes, where swelling can be particularly visible. The thinness of the lower eyelid skin also makes this area susceptible to irregularities after a superficial injection.
- Prolonged swelling : hyaluronic acid may promote water retention and worsen pre-existing oedema. This risk deserves particular attention in patients whose eye area regularly becomes swollen.
- Visible or palpable irregularities : a deposit of gel placed too superficially or an excessive quantity may create small raised areas under the skin.
- A bluish colour : when hyaluronic acid is injected too close to the surface, it may produce a Tyndall effect. This bluish tint differs from vascular dark circles or bruising caused by the injection.
At the practice, we consider that the expected benefit for hydration and fine lines does not justify these risks in this region. We favour other treatments according to the concern observed. This position concerns Skinboosters under the eyes ; however, we treat tear trough hollows with conventional hyaluronic acid injections suited to this indication.
Which treatments are available for fine lines and crepey skin under the eyes ?
Fine lines under the eyes may be related to dehydration, skin ageing or muscle contractions. Treatment must target their cause and take account of wrinkle depth, skin phototype and any eyelid laxity.
- Moisturising skincare : this is the priority when the skin is dry or irritated. It may reduce fine lines caused by dehydration. Redness, itching or flaking require investigation for a dermatological condition before any aesthetic treatment.
- Peels or laser treatment : these may improve certain fine lines and the crepey appearance of the skin. The technique and its intensity are chosen according to skin phototype and the condition of the eyelid. These treatments require precautions specific to the eye area.
- Botulinum toxin : this may reduce crow’s feet, located at the outer corners of the eyes, when they are caused by muscle contractions. It is not a routine treatment for fine lines on the lower eyelid.
These treatments address different concerns and are not interchangeable. Excess skin on the lower eyelid requires a separate assessment and may warrant a surgical opinion. The American Academy of Ophthalmology presents treatments for the eye area, including lasers, peels and eyelid surgery. The choice depends on the concern identified during the examination : fine lines, changes in pigmentation or excess skin.
Which treatment is suitable for tear trough hollows or under-eye bags ?
A tear trough hollow is a depression under the eye, whereas a bag forms a bulge. These two concerns may coexist, but their treatment differs.
- A tear trough hollow : treatment involves a hyaluronic acid injection intended to fill the hollow. The product is placed deeply, in an appropriate quantity. Dr Romano first checks for bags or oedema that could make the injection unsuitable.
- Fat bags or excess skin : injections remove neither fat nor excess skin. A specialist opinion allows the potential benefit of eyelid surgery to be assessed.
- Swelling caused by oedema : its cause must be investigated before any treatment. An injection intended to conceal it may worsen the swelling.
The presence of a hollow is therefore not enough to justify an injection. Treatment must take account of the entire under-eye region, particularly when the hollow is accompanied by bags or oedema.
