Eyes
Not all under-eye circles are the same. They may be caused by fat bags, a hollow tear trough, thin skin with visible vessels or pigment. First I work out which yours is; then I choose the technique. Treating a bag with filler, for example, makes it worse.
How I treat it
In consultation I look at the area from the front and in profile, with and without light, and assess the skin, fat, tear trough and eyelid support. Often there is more than one cause and I combine techniques in the same session.
When there are bags, the solution is surgical: lower blepharoplasty with fat transposition. I reposition the fat from the bag into the hollow, treating the bag and the hollow at the same time. If eyelid support requires it, I add a canthopexy.
When there are no bags, hyaluronic acid in the tear trough and in the areas that support it improves the hollow and the shadow. I use a small amount of a product suited to the area: here, more is not better.
As an alternative to hyaluronic acid, or alongside blepharoplasty, I fill the tear trough with microfat and use nanofat to improve thin lower-eyelid skin. I prepare the fat with dedicated equipment to obtain each type.
CO2 laser improves skin quality and fine wrinkles of the lower eyelid. If the darkness is due to pigment, I use picosecond laser; if vessels are visible, vascular laser.
After treatment
It depends on the technique. After hyaluronic acid there may be some swelling or a small bruise for a few days. After fat grafting there is swelling in the face and the donor area. After blepharoplasty there is swelling and bruising, and CO2-treated skin takes 5 to 14 days to recover.
Realistic expectations
Constitutional dark circles improve but rarely disappear completely. Filler does not treat bags and, when poorly indicated, can leave the eyelid puffy for months. If a technique is not going to help you, I will tell you.
Frequently asked questions
The most common are fat bags, a hollow between the eyelid and cheek, dark circles due to pigment and thin skin with visible vessels. Many people have a mixture. I distinguish them in consultation.
No. It works well in a tear trough without bags and to support the under-eye area. If there are bags, it can make things look worse, and surgery is a better option.
Yes. I use microfat to fill the tear trough and nanofat to improve thin lower-eyelid skin. It can be done on its own or with a blepharoplasty. Some of the fat is reabsorbed, so a touch-up is sometimes advisable.
When there are fat bags or excess skin. In that case I perform a lower blepharoplasty with fat transposition, combined with CO2 laser on the skin.
With filler, bruising, persistent swelling or irregularities. With surgery, swelling, bruising, asymmetry or changes in eyelid position. With laser, prolonged redness or pigmentation changes. We go through the ones relevant to you.
Hyaluronic acid costs from €350, fat grafting from €2,600 and lower blepharoplasty from €3,600. Sedation, when needed, is quoted separately, from €500. The initial consultation (€150) is not deducted from the treatment price.
General information to help you prepare for your consultation. Indications, risks and recovery are assessed individually; results vary between patients. Content reviewed by Dr Ignacio Torres Navarro, dermatologist (registration no. 46-24-287). October 2026.