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2026.08.23
The Effects of Lituo on the Under-Eye Area | A Doctor Explains Treatments for Dark Circles, Fine Lines, and Hollows
Engaged in both aspects of cosmetic dermatology and cosmetic surgery, he is an all-rounder doctor who pursues natural and elegant beauty with "the best interest of the patient" as his first priority. He is also a board-certified cosmetic surgeon by the Japanese Society of Aesthetic Plastic Surgery (JSAS). He specializes in hyaluronic acid injections, thread lifts, and facial surgery, and is a competent KOL (Key Opinion Leader) for ARTEMISLIFT and Hydro Rejuran. He is always sensitive to the latest trends and is always exploring knowledge and techniques.
Rituo is an injectable treatment used for fine lines under the eyes, loss of firmness, dark circles, and hollows. It is important to assess the condition of the eye area and identify the underlying causes in order to select the appropriate treatment.
I’m sure many of you are wondering, “Can I use Rituo under my eyes?” and “How effective is it for dark circles and fine lines?”
Rituo (Re2O·Bunaju) is a collagen preparation whose main component is human acellular dermal matrix (hADM).
At BIANCA CLINIC, we do not simply categorize eye area concerns as “dark circles” or “wrinkles”; instead, we assess the condition of the skin, any hollows, and fat deposits to determine the most appropriate treatment. Here, we explain the effects of Retuo on the under-eye area and how to choose between it and other injectable or surgical treatments.
What kinds of under-eye concerns can Rituo be used for?
Rituo is an injectable treatment option for those concerned about fine lines around the eyes, loss of firmness, dark circles, or hollows. Suitability is determined following an examination of the condition of the eye area.
Even when I'm not smiling, I'm self-conscious about the fine lines around my eyes.
One of the reasons people seek treatment for the eye area is because they notice, “Fine lines have started to appear under my eyes—not just when I smile, but even when I’m not doing anything.”
Rituo is a treatment that improves the firmness and texture of the eye area while replenishing components such as collagen that support the skin. It is an option for those who want to improve the skin itself rather than add significant volume.
Dark circles and hollows make you look tired
If you feel like you “look tired even though you’re getting plenty of sleep” or are “concerned about the shadows under your eyes,” dark circles or hollows under your eyes may be the cause.
Although Rituo can be used under the eyes, there is no single cause of dark circles. The appropriate treatment varies depending on what is causing the shadow—such as skin thickness, skin tone, hollows, or bulging fat.
Therefore, rather than simply assuming, “It’s dark circles, so it must be Lituo,” it’s important to first check the condition of the area around your eyes.
The entire eye area looks sunken.
As people age, some may notice that “the skin around their eyes has lost its firmness” or that “they seem to have lost some of their vitality.”
With these changes, it’s not just a matter of a simple lack of volume; the texture of the skin itself may also be a factor. Rituo is one treatment option to consider when you want to improve the skin from the foundation up, rather than drastically altering the appearance of the eye area.
In addition to the eye area, for information on the changes you can expect for your entire skin with Rituo, as well as when you’ll start to see results, the number of treatments required, and how long the effects last, please see “What Are the Effects of Lituo? A Doctor Explains When You’ll Start to Feel the Effects, How Often to Take It, and How Long They Last" explains this in detail.
Lituo's Under-Eye Treatment: A Look at Case Photos (Part 1)
Treatment Period and Number of Sessions: Left: Before Surgery; Right: 1.5 Months After Surgery
*This graph shows the skin condition ranking (percentile) compared to peers of the same age. Yellow represents the pre-treatment assessment, and purple represents the assessment 1.5 months after treatment. An increase in the score is evident after treatment, confirming that the condition of wrinkles has improved to a better level compared to peers of the same age.
Side Effects and Risks: Swelling, redness, puffiness, small nodules, etc.
Cost: 115,500 yen per session; topical anesthesia fee: 3,630 yen
*The photos shown are for illustrative purposes only. Results and progress may vary from person to person.
Why does using Rituo under the eyes help achieve a natural-looking result?
Rituo is a treatment designed not to add significant volume, but to replenish ingredients that support the skin and improve the texture of the eye area.
Replenishes ingredients that support the skin and improves the texture of the eye area
Rituo is an injection treatment that uses hADM derived from human dermis. It replenishes the skin’s supportive components—such as collagen and elastin—while improving firmness and texture.
The key point here is that this is “not a treatment designed to plump up the area under the eyes.” Rather than drastically changing the appearance of the eye area, the goal is to improve the condition of the skin itself.
For detailed information on the ingredients and how Rituo works, see “What Is Lituo Re2O (Bunaju)? An Easy-to-Understand Explanation of Its Expected Effects, Benefits, and Drawbacks" explains this in detail.
Even a slight difference in volume around the eyes can easily change your appearance.
When it comes to injectable treatments for the eye area, my focus isn’t limited to just choosing the right product.
The area under the eyes is a part of the face where even slight differences in fullness or hollowness can easily change the overall impression of the face. That is precisely why it is necessary to carefully consider where, at what depth, and in what quantity to inject the filler.
At Bianca Clinic, our doctors adjust the injection site, depth, and volume while carefully assessing your skin condition and the balance of your eye area.
It serves a different purpose than treatments designed to restore volume.
Even if the concern is the same—"I'm worried about the area under my eyes"—the treatment will vary depending on whether the main issue is a lack of skin firmness or shadows caused by hollows.
Rituo, which is designed to improve skin texture, and hyaluronic acid, which fills in depressions and restores lost volume, serve different purposes in treatment.
It’s not a matter of which one is better; what’s important is to determine what your eyes need right now and choose accordingly.
Rituo alone may not be enough to treat dark circles, wrinkles, and hollows under the eyes.
Concerns about the under-eye area can stem from various causes, such as the skin, hollows, fat, or discoloration. In some cases, injection treatments or surgical procedures other than Rituo may be more appropriate.
When it comes to concerns about the under-eye area, it's important to identify the cause
Even during consultations, we sometimes have patients who say, “I’m concerned about the wrinkles under my eyes, but there are so many treatment options that I don’t know which one to choose,” and are unsure of what to do.
In fact, there are various options for eye area treatments, ranging from injectable treatments such as Rituo, baby collagen, and hyaluronic acid to surgical procedures.
That is precisely why, rather than deciding on a treatment name right away, it’s important to first identify the root causes of your eye area concerns.
How to Choose Between Rituo, Baby Collagen, and Hyaluronic Acid
In addition to Rituo, there are several other options for dermal filler treatments around the eyes.
Baby collagen-based treatments are used to achieve a natural-looking result for fine lines around the eyes, dark circles, and nasolabial folds. On the other hand, if hollows or volume loss are the primary causes, hyaluronic acid injections may be a good option.
The important thing is not to simply decide, “Since it’s under the eyes, I’ll use this product.” Instead, we determine which layer needs what kind of treatment during the consultation and select the appropriate treatment accordingly.
Choose between injectable and surgical treatments based on the cause of your under-eye concerns
In cases where fat under the eyes protrudes forward and casts a shadow, or where there is significant skin sagging, it may be difficult to achieve sufficient results with injection treatments alone.
In such cases, surgical options include transconjunctival blepharoplasty, the reverse Hamra procedure, and lower eyelid lift surgery.
At Bianca Clinic, we don't limit our approach to cosmetic dermatology injection treatments alone; we are also able to consider cosmetic surgical options as needed.
Even if you express a desire to undergo Lituo treatment, if we believe another method would be more appropriate, we will explain your treatment options, including the reasons for our recommendation.
Lituo's Under-Eye Treatment: Case Photos Part 2
Treatment Period and Number of Sessions: Left: Before Surgery; Right: 1 Month After Surgery
*This graph shows the ranking (percentile) of skin condition compared to the same age group. Yellow is the evaluation before the treatment and purple is the evaluation at one month after the treatment. After the treatment, an increase in score is observed, and it can be confirmed that the wrinkle condition has improved to a more favorable level compared to the same age group.
Side Effects and Risks: Swelling, redness, puffiness, small nodules, etc.
Cost: Lituo Re2O (Bunaju): 110,000 yen per session; topical anesthetic fee: 3,630 yen
*The photos shown are for illustrative purposes only. Results and progress may vary from person to person.
Downtime and Precautions After Rituo Injections Under the Eyes
After a Lituo treatment under the eyes, you may experience redness, swelling, puffiness, or bruising. The recovery process varies from person to person.
Redness, swelling, puffiness, and bruising
After a Lituo treatment, temporary redness, swelling, or puffiness may occur at the injection site. Additionally, because needles or cannulas are used, bruising may occur in rare cases.
Mild redness and swelling will subside within a few hours to a few days, and if bruising occurs, it will gradually fade over the course of about 1 to 2 weeks.
What to Do After Your Treatment: Makeup, Bathing, and More
Except for the treated area, you may apply makeup starting on the day of the procedure. You may take a shower on the same day, but it’s generally recommended to wait until the next day or later before taking a bath.
On the day of your treatment, please refrain from strenuous exercise, drinking alcohol, taking long baths, and vigorous massage of the treated area.
Things to Keep in Mind, Especially Around the Eyes
Since the area under the eyes is where changes are most noticeable, please allow plenty of time if you plan to have the procedure done right before an important event.
In particular, bruising may last longer than redness. If you have plans such as a photo shoot or an event, please consult your doctor in advance about the treatment date.
If you would like more detailed information about the progression of redness, swelling, puffiness, and bruising, as well as how to care for yourself after the procedure, please see “How Many Days Is the Downtime for Re2O? A Doctor Explains Symptoms, Recovery Process, and Post-Treatment Precautions"Please also refer to this."
Frequently Asked Questions About Litou's Under-Eye Treatment
Here are answers to your questions about the effects of using Rituo under the eyes on dark circles and fine lines, how it differs from hyaluronic acid, and the results and any discomfort involved.
Q. Can Lituo be used on dark circles under the eyes?
A. Lituo is sometimes used to treat dark circles under the eyes. However, since dark circles can have multiple causes—such as pigmentation, blood flow, hollows, or protruding fat—we will determine the cause during an examination and then discuss treatment options.
Q. Can Rituo be expected to be effective against fine lines under the eyes?
A. Fine lines around the eyes are one of the areas targeted by the Rituo treatment. While the treatment aims to replenish ECM components and improve skin firmness and texture, the results may vary from person to person.
Q. Is there a difference in how Rituo and hyaluronic acid are used under the eyes?
A. They serve different purposes and are used depending on the condition. Rituo is designed to improve the skin’s foundation, while hyaluronic acid is used to physically fill in hollows and restore lost volume.
Q. Won't getting Rituo injections under my eyes look unnatural?
A. Lituo is not a product primarily designed to create significant volume. However, because the eye area is delicate, the final results depend on factors such as the injection site and the amount injected. We will develop a treatment plan based on your consultation.
Q. Does it hurt to have Rituo injected under the eyes?
A. Since this is an injection treatment, you may feel some discomfort or pressure when the needle is inserted. At our clinic, we use topical anesthesia and microcannulas to minimize any discomfort, but since pain sensitivity varies from person to person, please feel free to consult with us if you have any concerns.
If you're concerned about the area under your eyes, identify the cause and choose the treatment that's right for you.
Rituo is a skin booster used to treat fine lines under the eyes, loss of firmness, dark circles, and hollows. However, concerns around the eyes can stem from a variety of causes—not just the condition of the skin—such as hollows, bulging fat, and sagging.
For this reason, it is important to consider not only Lituo but also injection treatments such as baby collagen and hyaluronic acid, and even surgical procedures if necessary.
At BIANCA CLINIC, we identify the specific reasons why you’re concerned about the area under your eyes and determine the best approach based on your desired results. If you’re unsure whether Rituo is right for your eyes, please feel free to discuss it with us during your consultation.
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