Dark Circles Under Eyes — Periorbital Rejuvenation

The dark circles treatment at S-thetics Beauty targets periorbital hyperpigmentation and under-eye volume loss — two of the most common and most visible signs of facial fatigue and ageing. The primary approach is hyaluronic acid tear trough filler (Stylage) placed along the orbital rim to restore volume in the hollow under-eye area, reducing the shadow that gives skin the dark, sunken appearance. Tear trough filler is one of the most technically demanding facial injection zones due to the thin skin, proximity to the eye, and complex anatomy of the inferior orbital rim — a zone where MDDr. Darina Šanšašvili's training in facial aesthetics and orofacial anatomy is directly applicable. Results are typically immediate and last six to twelve months. Consultation with MDDr. Šanšašvili establishes which component of the dark circle (volume loss, pigmentation, or both) is most prominent and which approach — filler, PRP, or a combination — is most appropriate.

Dark circles under the eyes have multiple anatomical and physiological causes, and the effective treatment depends on identifying the dominant mechanism in each individual client. The three main contributors are: (1) volume loss in the tear trough and infraorbital area, creating a hollow shadow that reads as dark; (2) visible subcutaneous pigmentation from dilated vessels, the orbicularis oculi muscle showing through thin skin, or post-inflammatory melanin; and (3) skin thinning and textural changes that increase translucency and reduce the skin's ability to scatter the dark underlying structures. At S-thetics Beauty, the primary treatment tool for volume-related dark circles is hyaluronic acid filler — specifically Stylage L or Stylage M placed along the tear trough and inferior orbital rim. The tear trough is the anatomical groove between the lower eyelid and the cheek that deepens as the medial cheek fat pad descends with age, creating a concavity that casts a shadow across the lower lid. Filling this groove restores the smooth, continuous surface between eyelid and cheek that characterises a youthful periorbital area. The correction is immediate and visible within a few days once any initial puffiness resolves. This is technically one of the most sensitive facial filler zones. The skin of the lower eyelid is the thinnest on the face — typically 0.5mm — and the injectable depth must be precise to avoid superficial placement (which causes a visible blue-grey discolouration called the Tyndall effect from HA scattering light in shallow tissue). MDDr. Šanšašvili's advanced facial aesthetics training and grounding in orofacial anatomy specifically prepare her for the layered tissue understanding needed in this zone. For cases where pigmentation (rather than volume) is the primary cause, additional modalities may be considered — including PRP (platelet-rich plasma), which is noted on the MEDICDENT sister site as available, or topical treatment protocols. The combination of filler for volume and PRP for skin quality addresses both mechanisms simultaneously in appropriate candidates. Bruising is the most common side effect in this area due to the density of small vessels, and can last five to ten days. Applying ice in the immediate post-procedure period and avoiding blood-thinners in advance reduces this risk significantly. Preparation: avoid blood-thinning medications and supplements for five to seven days. No alcohol 24 hours before. Sleep elevated for the first two nights post-treatment to minimise pooling of any post-procedure oedema. Avoid rubbing the area for two weeks. Contraindications: active periorbital infection or eye inflammation, known HA allergy, autoimmune orbital conditions, thyroid eye disease (Grave's ophthalmopathy), and recent retinal or optic nerve surgery.