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2025.11.15
Why Do Dark Circles Form? ⸻ Explaining the Structural Reason They Stand Out as Shadows
As a board-certified plastic surgeon, I have handled numerous cases involving trauma, reconstruction, and congenital conditions, cultivating precise techniques and deep anatomical understanding. Driven by the desire to deliver the transformative power of beauty—where visible change uplifts the spirit—I pursued a career in cosmetic surgery. My areas of expertise include comprehensive eye treatments, injectable therapies, and anti-sagging procedures. Guided by a commitment to sincerely address each patient's aspirations, I provide meticulously crafted treatments focused on achieving beauty.
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Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
We often hear concerns like "I'm worried about my dark circles," "I look tired," or "My dark circles don't go away even after sleeping a lot." However, dark circles aren't simply caused by lack of sleep or fatigue.
There are various factors that cause dark circles under the eyes,The true nature of dark circles, which trouble most people, is “shadow.”and the shadow is created by the structure of the lower eyelid itself.
This time, I'll explain as clearly as possible why dark circles form and why they stand out as shadows.
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■ Why Bears Stand Out as “Shadows”
The reason shadows form is very simple:Because the light is shining down from above.」です。
Our faces are constantly illuminated from above by light sources such as the sun or room lighting,
Swollen area (protrusion) → Indentation (step) below it
This structure will inevitably cast shadows.
Source: 'Facial Plastic Surgery, 1st Edition' (Nihon Iji Shinposha, 2021) p.74, Figure 1, modified and reproduced
This combination of “swelling × indentation” is the fundamental mechanism that makes dark circles appear more pronounced.
• Bulging (protrusion of orbital fat forward)
• Hollows (tear troughs or mid-cheek grooves)
The deeper the shadow, the darker it becomes, making it easier to recognize as a dark circle.
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■ Why Fat Bulges Occur
The Truth Behind Lower Eyelid “Puffiness” Orbital fat is.
Source: 'Facial Plastic Surgery, 1st Edition' (Nihon Iji Shinposha, 2021) p.74, Figure 1, modified and reproduced
This fat is located immediately beneath the eyeball and is normally supported by a strong ligament called the "Rockwood ligament."
However, as this ligament loosens with age,The weight of the eyeball is now directly transmitted to the underlying fat, resulting inasThe orbital fat is being pushed forward.
Furthermore, the amount of orbital fat naturally varies from person to person,For those with a higher body fat percentageConcerned about breast development since my teensIt's not uncommon to hear people say that.
Furthermore,Skin・orbicularis oculi muscle(lower eyelid muscles)Orbital septum(the membrane surrounding fat)loose with ageTherefore, the protrusion becomes more pronounced.
In other words,
Looseness of the Lockwood ligament × Looseness of the orbital septum × Looseness of skin and muscle × Individual differences in fat volume
These factors combine to cause the lower eyelid to become puffy.
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■ Reasons for the Appearance of Tear Troughs
tear trough is, "Orbicularis Oculi Ligament (ORL)The ligament known as the "ligament" is involved.
Ligaments are tissues that attach skin to bone.is.
The area where this ligament is tightly stretched is stiff and difficult to move, causing the skin to appear sunken only in that spot.
Furthermore,Occurring with ageBone atrophy(Changes where the bone becomes thinner and recedes deeper) also affects.
Ligaments are attached to bones, so when the bone recedes inward, the ligaments also retract, resulting in the skin-side indentation appearing deeper.
there Orbital fat bulge As they overlap,
• The upper part has fat protruding forward
• The lower part sinks due to ligament damage and bone atrophy
that“A gap” has emergedwhen light hits itDark circles under the eyeswill be more easily recognized as.
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■ Why the mid-cheek groove appears
The mid-cheek groove is a depression that forms below the tear trough, primarilyMidface volume loss (central cheek area)is involved.
As cheek fat sags downward with age, upward support weakens, causing the boundary line (i.e., the hollow) to become distinctly visible.
Furthermore Atrophy of the maxillaAs the base recedes, the indentation appears deeper.
Insidenasojugal grooveand there was also a dip,creates a continuous shadow along the tear troughTherefore, more “linear shadow”tends to be emphasized."
When the tear trough and nasojugal-mid-cheek groove overlap, shadows connect from under the eyes to the cheeks, making dark circles appear significantly darker.
This is what is known asGolgo Lineis.
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■ Sagging skin is also a cause of noticeable dark circles
Not only fat and ligaments,Skin saggingThis also causes shadows to appear more pronounced.
Skin sags downward due to excess / The lower eyelid contour becomes indistinct. Shadows tend to fall over a wider area, etc.
Especially for those in their 40s and older,
"Fat bulge × tear trough × mid-cheek × skin laxity"
Because the combination often results in stronger shadows, treatment also requires a combination approach.
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■ Summary
The essence of dark circles that can be treated with surgery is all about "The shadows created by the protrusions and depressions, accentuated by the light」is.
• Orbital fat protrudes forward
• Deep tear troughs
• The mid-cheek area is sunken
• Skin is sagging
The more these elements accumulate, the darker the shadow appears.
In bear treatment,The most important thing is how to eliminate this gap.So,Liposuction, fat transfer (Hamra method), fat grafting, rhytidectomy (excess skin removal), etc.Address each cause accordinglySurgery will be necessary.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
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