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Several factors can explain a less luminous-looking gaze
- Natural and biological causes: skin ageing, loss of sub-orbital volume, thinning of the skin, reduced elastin and collagen production.
- Genetic and anatomical factors: pigmented or hollow dark circles, predisposition to under-eye fat bags.
- Lifestyle and environment: lack of sleep, stress, smoking, alcohol consumption, diet, sun exposure.
- Specific factors: allergies, local circulatory disorders, certain medications.
These phenomena are normal and evolve over time. Their origin can be understood through a clinical examination, in order to propose suitable, progressive approaches.
Possible solutions
Depending on the cause and the wishes of the patient, several options may be considered. Two broad categories of procedures exist: aesthetic medicine and aesthetic surgery.
Aesthetic medicine
- Hyaluronic acid injections (treatment of hollow dark circles): localised restoration of sub-orbital volume to soften the shadow and reduce the hollow appearance. The procedure is performed at the practice and adapted to the anatomy.
- Botulinum toxin injections (expression lines): targeted treatment of dynamic wrinkles around the eyes (crow's feet) to soften the expression.
- Peels, skin boosters and resurfacing techniques (laser, radiofrequency): improvement of skin quality, reduction of spots and improvement of hydration and texture for a brighter gaze.
Aesthetic surgery
- Lower blepharoplasty: correction of fat bags and improvement of the sub-orbital contour to reduce the tired appearance.
- Upper blepharoplasty: removal or repositioning of excess skin and tissue of the upper eyelids when it alters the openness of the gaze.
- Lipofilling (fat micrografting): restoration of volume around the eyes using autologous fat to fill hollows and harmonise the orbital contour.
The choice between these options will depend on the clinical examination, the extent of the concerns (pigmentation, volume loss, bags) and the expectations expressed during the consultation.
Management pathway
- Initial consultation: assessment of the eye and eyelid area, analysis of the causes (volume, skin, pigmentation), discussion of expectations and medical history.
- Personalised plan proposal: choice of suitable techniques, explanation of the possible benefits, limitations, risks and treatment schedule.
- Care modalities: procedures at the practice (for most aesthetic medicine treatments) or in the operating theatre (for surgery). Information on pre-operative steps, any anaesthesia and the recovery period.
- Follow-up and safety: check-up appointments, monitoring of the recovery and adjustments if necessary. Priority is given to dialogue and to a gradual approach to treatment.
Expected results and follow-up
Realistic goals are an improvement in the brightness of the gaze, harmonisation of the eye contour and a natural result suited to the face. Results vary depending on the individual, the severity of the concern and the type of procedure chosen. Some treatments require regular maintenance (injections, skin boosters), while others provide a more lasting correction (blepharoplasty, lipofilling). Regular medical follow-up allows progress to be assessed and procedures to be adapted over time.