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Hello,Plastic Surgeon Ryutaro Natsumeis.

When I catch a glimpse of myself in the mirror or look at a photo, I notice the dark circles under my eyes and feel my spirits sink.

"Even after sleeping, you still look tired." "You look older than you are." — Have you ever had that experience?

First, start by correctly identifying the cause of your dark circles.

This article provides an easy-to-understand explanation from an expert's perspective on the types and causes of dark circles, along with the appropriate treatments for each.

This content is especially for those who feel they don't know what suits them.

 

Types of Dark Circles Under the Eyes and Their Treatments

Dark circles under the eyes are primarily classified into three types: dark circles, blue circles, and brown circles.

・Dark circles:This refers to dark circles caused by shadows due to unevenness in the lower eyelid. It is a good candidate for surgery.

・Dark circles under the eyes:

This refers to dark circles caused by the blue tint appearing through the orbicularis oculi muscle or subcutaneous venous plexus due to the thin skin of the lower eyelid.

Prolonged use of computers or smartphones, lack of sleep, fatigue, and lack of exercise can also worsen the condition due to poor blood circulation.

It is necessary to review lifestyle habits such as staying warm, resting your eyes, and getting moderate exercise.

If the orbicularis oculi muscle is being pushed to the surface by orbital fat, dark circle surgery can be expected to improve the condition.

Another method involves injecting fat between the skin and orbicularis oculi muscle, or using skin-enhancing injections like Snekos to stimulate collagen production in the dermis for improvement.

・Dark circles under the eyes:

This refers to dark circles caused by pigmentation. It is thought to be caused by chronic mechanical irritation, such as rubbing the eyes.

Sufficient moisturization and non-surgical treatments such as hydroquinone and chemical peels are effective.

 

【The Mechanism of Dark Circles and Treatment Goals】

①: Orbital fat bulge ②: Tear trough ③: Mid-cheek groove

 

・Bulge at ①

・Looseness of the ligaments below ② and ③ + indentation caused by reduced surrounding fat between ② and ③

When the resulting unevenness becomes noticeable, dark circles appear.

① acknowledges that even individuals in their teens can have high body fat levels,

The grooves in areas ② and ③ are formed because ligaments connect skin to bone; particularly with age-related changes, when bone atrophy occurs, the skin also sinks in.

② typically begins to deepen gradually from around the age of 20, while ③ starts to appear around the age of 40.

This explanation of sagging also covers similar points.　https://biancaclinic.jp/blog/43052/

 

◎Treatment Strategy

◎When only ① applies:

・Degreasing

The mucous membrane behind the eyelid is incised, and excess orbital fat is removed.

When performing surgery solely for fat removal while the groove between ② and ③ is present, it can result in sunken-looking eyes, so caution is required.That's it!

(Top: Pre-operative / Bottom: 1 month post-operative)

 

◎Case ① + ②/③:

・Urahamura Method

Make an incision in the mucous membrane behind the eyelid, then shift the bulging excess fat (①) into the groove (②/③) to smooth out any unevenness.

This case also involved simultaneous double eyelid surgery and epicanthoplasty.

(Top: Pre-operative / Bottom: 1 month post-operative)

 

・Frontal Hamra Method

In cases of significant skin laxity, an incision is made near the eyelashes,Slide the bulging excess fat from ① into the groove between ② and ③ to smooth out the unevenness.

Method for assessing skin laxity: If you can pinch a significant amount of skin from the lower eyelid while opening your mouth wide and looking upward, this indicates considerable skin laxity.

 

・Fat removal + fat grafting

When the forehead, temples, and cheeks are sunken

After removing the appropriate amount of fat, the harvested thigh fat is finely separated and impurities are removed. It is then injected to fill the depressions in areas ② and ③.

At the same time, it is injected into areas with low fat content. It may also be combined with facial liposuction.

(Left: Before surgery Right: 3 months after surgery Fat removal + fat grafting (upper eyelids, lower eyelids, nasolabial folds, forehead, temples))
)

 

◎When ①＋②/③, especially if the outer indentation of ③ is pronounced, or if there is significant sagging along the nasolabial folds:

・Midface Lift

In addition to the Hamra approach, we lift the midface fat to eliminate unevenness, including areas with pronounced hollows.

 

◎When only ②/③ apply:

・Injection therapy (fat injection,Baby collagen injections, etc.

For those afraid of surgery or unable to take downtime, Baby Collagen injections can give you beautiful results like this immediately after treatment.

Treatment is possible even with slight swelling.

(Left: Before surgery; Right: Immediately after surgery - Baby Collagen Injection)

 

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By improving dark circles, you'll see not only a change in appearance, but also...

We often hear comments like, "I've started enjoying dressing up," and "My sales performance has improved."

The impression made by your eyes affects your daily life and mood more than you might realize.

Aesthetic medicine is not merely about “changing your appearance”; it is also a means to “shine more authentically as yourself.”

We will carefully examine you and provide recommendations to help resolve your eye area concerns in a way that is comfortable and natural for you.

If you have the preconception that "bear treatment equals plastic surgery," please feel free to consult us with confidence.

We hope this will be the first step in refining your “impression beauty.”

 

Reservations can be made here.

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※There are various approaches to aesthetic medicine, and opinions and practices may differ among physicians. Please consider the information provided here as one reference only, and we hope you will choose medical care that suits you and meets your expectations.

We apologize if any unintended inaccuracies or misleading expressions were included. In such cases, we will make appropriate corrections or additions.

【Profile】

Plastic Surgeon Dr. Ryutaro Natsume

https://biancaclinic.jp/doctor/natsume/

Performed numerous facial surgeries, particularly focusing on the eye area and facial bones, in the field of plastic surgery.

Regarding treatments for the eye area, I believe that not only aesthetic appearance but also ophthalmic functionality is extremely important. To provide safer and more reliable treatments, I am currently deepening my expertise as an ophthalmologist.

We actively incorporate non-surgical procedures such as hyaluronic acid injections, in addition to treatments requiring surgical instruments.

From a multifaceted professional perspective encompassing cosmetic surgery, cosmetic dermatology, reconstructive surgery, and ophthalmology

BIANCA CLINIC, a leading Japanese clinic specializing in beauty and regenerative medicine, provides the latest aesthetic treatments.

【Career】

2020: Graduated from Tokyo Medical University Tokyo Metropolitan Saiseikai Central Hospital

2022 Jikei University Hospital Department of Plastic Surgery

2023 Department of Plastic Surgery Jikei University School of Medicine Kashiwa Hospital

2024 BIANCA CLINIC

【Professional Affiliations/Qualifications】

Japanese Society of Aesthetic Surgery (JSAS)

Full Member of the Japan Society of Plastic and Reconstructive Surgery

Full Member of the Japanese Society of Craniofacial Surgery

Full Member of the Japanese Ophthalmological Society

【SNS】

Instagram account　

 https://www.instagram.com/dr.natsume?igsh=OHBvd3VtajV1bmY1&utm_source=qr