Under Eye Treatments

Under Eye Treatments

Tissue Fillers

Under-eye filler with Ashley Miguel, PA-C - RentonHyaluronic acid fillers, such as Restylane and JUVÉDERM™, can be used to improve dark circles and hollowed tear troughs. Tissue fillers work by "filling" in the grooved area and lifting the more superficial skin layers to smooth out shadows and lines. The injection takes only about 30 minutes to complete, and results are visible within a couple of weeks. Side effects include mild swelling and possible bruising.

Dr. Reichel is skilled at the advanced techniques for these injections and are clinician trainers in the use of hyaluronic acid fillers.

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What Kind of Under Eye Symptoms Can Dr. Reichel Treat?

Dark Circles

Dark Circles under the eyes give a false appearance of being tired, and can make you look older than you are. Although the cause is not fully understood, we know that dark circles can be genetic. They tend to worsen with age, and do seem more pronounced when we are tired, ill, or stressed.

Hollowness Under The Eye

Hollowing of the tear trough (the groove under the eyes) happens as we age. The hollowness is typically due to upper cheek fat loss with sagging of the cheek's upper muscles ("midface descent"). The hollowed appearance causes us to look older.

Loose Skin and Under Eye Wrinkles

Loose skin and under eye wrinkles increase as we age. Lines and loose skin under the eyes make us appear tired even with a good night's rest. Chronic sun exposure is one cause of lines and excess skin. Smoking can also be a cause. Of course wrinkles are also a result of the expressions that we make.

"Bags" Under the Eyes

Bags under the eyes are caused by bulging of the Orbital Fat Pads as we age. Bagging and sagging under the eyes can cause the face to look tired, aged, and "sad".

What Kind Of Under EYe Treatments Are Available?

Specially Formulated Eye Creams

Eye creams are specially formulated for the fine skin under and around the eyes. Regardless of the ingredients, eye creams mainly give moisture to the skin. For dark circles, some eye creams contain ingredients that may help temporarily by "plumping" the skin. For the most part, the tissues will return to the way they were when you discontinue the treatment.

We do recommend nightly use of an eye cream. The extra moisture each night helps to smooth lines and keep your eyes bright and healthy. You don't have to spend a fortune – we love the Skin Medica Night Eye Repair, and carry it here at Pacific Dermatology & Cosmetic Center. Many other over-the-counter brands are also good.

Autologous Fat Transfer

Fat injections can improve the hollows and dark circles under the eyes. Ones' own fat is the most natural and pliable filler available and, there is no risk of an allergic reaction. Fat injections can be permanent, but for some patients they last from 1 to 2 years. We usually do fat transfers in a series of three to four injections spaced 3 months apart. Please call to schedule a consultation with Dr. Reichel to discuss the details.

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BOTOX® Cosmetic

Close up of woman receiving botox injection under eyeBOTOX® injections act to relax muscles and smooth lines on the face. For some patients, the use of a very small amount of BOTOX® under each eye can really make a difference. Try smiling in the mirror. Do you have a bunching or bulging of skin just under the lower eyelid margin? If so, you could be a candidate for under eye BOTOX® injection into the orbicularis oculi muscle. It takes only a few minutes and can relax and rejuvenate the lower eye complex. In addition, treatment of the crow's feet can really open the eyes and improve the over-all appearance of the eyes. We like to pre-treat patients with BOTOX® when we do Fractional CO2 laser resurfacing around the eyes. When the muscles are at rest, the laser resurfacing is even more effective.

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Lower Lid Blepharoplasty

Removal of bulging orbital fat and excess skin from below the eye can improve the aged appearance and "bags" under the eyes. A consultation with Dr. Reichel would be needed to determine if this is the right procedure for you.

Dr. Reichel does lower lid blepharoplasty via the transconjunctival approach. During her cosmetic and skin cancer fellowship, Dr. Reichel trained with the leading oculoplastic and facial plastic surgeons to learn this technique.

During transconjunctival lower lid blepharoplasty, the eyeball is protected by a plastic plate. The lower lid is retracted down and away from the eye. The initial incision is made with an electrocautery cutting device along the inside of the eyelid (conjunctiva).

    • A step-wise conservative removal of fat is undertaken from one, two, or all three of the fat pads, thereby sculpting the lower eyelid into its new shape.
    • Care is taken to leave some of the lid's fullness intact, as a hollowed eyelid suggests aging rather than youth.

Several options for treating loose or wrinkled skin may be considered along with transconjunctival lower blepharoplasty:

  • We can soften wrinkles, improve skin quality, and tightened the skin of the lower eyelid with Fractional CO2 (Total FX) treatment at the same time as your eyelid surgery.
  • When indicated, a tiny strip of skin may be pinched and then excised from the area just below the lashes. This is called a lower lid Pinch Blepharoplasty.

Fractional CO2

Fractional CO2 (Total FX) laser resurfacing can be used around the eyes to improve pigment, wrinkles, and loose skin. This procedure can be combined with a full face treatment or done just around the eyes. The treatment involves use of a sophisticated CO2 laser that puts down deep and superficial pin point columns of laser light to vaporize cells and tighten the skin. A fractional CO2 treatment takes a couple of hours. Most patients heal within 5 days.


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Thank you for choosing Pacific Dermatology & Cosmetic Center, we look forward to providing you with the very best skin care.