The Science Behind Dark Circles: Understanding Tear Trough Deformity and Effective Solutions

눈밑꺼짐 눈물고랑

Have you ever wondered why tear grooves form and what sets them apart from dark circles? In this article, we’ll unravel the mysteries behind under-eye issues, exploring the difference between tear trough deformity and dark circles. Discover how under-eye fat repositioning surgery can significantly enhance the under-eye area, diminishing wrinkles and rejuvenating your appearance.

Under eye fat repositioning surgery can improve not only sagging under the eyes but also dark circles. But do you know why tear grooves form and what makes them different from dark circles? We will tell you about the difference between the two and introduce how much better you can improve under-eye fat relocation, which improves wrinkles under the eyes, with a review of under-eye fat relocation.

1. What is the naso-jugal groove or tear trough deformity?

Tear troughs, those semicircular depressions under the eyes and on the nose, can be a common concern as we age. While some individuals naturally have a slight depression in this area, aging often accentuates the sunken appearance due to the deformation of the surrounding fat under the eyes.

2. Why do tear grooves form?

Facial bones play a crucial role in supporting the tissues around the eyes.

눈 유지인대
The retaining ligament surrounding the eye (right eye) 
Ref) Facial soft-tissue spaces and retaining ligaments of the midcheek: defining the premaxillary space

The orbital retaining ligaments, resembling a ring around the eye, become more pronounced as we age. Initially, when these ligaments hold the skin and muscle tightly, the tear trough may be less noticeable. However, as aging progresses, surrounding tissues sag, fat diminishes, and bones recede, making the tear troughs more prominent.

3. How are Dark Circles and Tear Troughs Different?

Dark circles can result from various factors, encompassing the following categories:

  • Pigmentation of the Skin Itself:
    If you’ve noticed dark circles since a young age, they may stem from inherent pigmentation issues. Toning lasers and similar treatments can enhance pigmentation.
  • Thin, See-Through Skin:
    Thin skin can make underlying structures visible. Nano fat transplantation is an effective method to reduce the visibility of dark circles by providing coverage.
  • Shadow Phenomenon:
    Shadows beneath the eyes contribute to the appearance of dark circles. Fat relocation or lower eyelid surgery may be necessary, especially if a shadow is caused by darkening. Often, a combination of procedures is required due to the multifaceted nature of dark circle causes.

4. Does the Lower Lid Get Elongated with Age?

눈밑노화 비교
Picture of my 20’s and 40’s. The lower lid looks lengthened as I get older.

As we age, the once inconspicuous boundary between the lower lid and cheeks may become more pronounced, accompanied by sagging and tear grooves. This can give the illusion that the lower eyelids have stretched.

눈밑 노화 모식도
1= palpebromalar groove. 2 = tear trough. 3 = midcheek groove.

The area beneath the eyes, commonly referred to as the sky blue area, is often the initial indicator of facial aging. To address this, lower eyelid surgery or under-eye fat repositioning can be effective.

5. Lower Blepharoplasty and Fat Repositioning Under the Eyes

The core principle of eye surgery involves manipulating fat to create a softer boundary between the lower eyelid and cheek, thereby blending the lid-cheek junction. This is achieved by cutting the extraocular ligament.

결막하 눈밑지방재배치
34 years old, 1 year after subconjunctival subconjunctival
Ref) Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

To maintain the softened border and prevent the recurrence of the severed retaining ligament, fat is transferred (fat relocation). If insufficient, fat transplantation is considered. For more comprehensive information on the treatment of under-eye bags, click here.

6. Conclusion

Dark circles are considered one of the signs of aging, often exacerbated by under-eye hollows and tear troughs. Treating these dark circles depends on the underlying causes, categorized into cases where pigmentation is the sole issue (addressed with laser treatments) and more complex situations requiring a combination of treatments (laser + surgery). The challenge lies in identifying the exact cause of dark circles before initiating treatment. Another difficulty in treatment is the multifaceted nature of its origins, necessitating a combination of various procedures. Some patients may hesitate to start treatment due to the uncertainty of pinpointing the exact cause. However, surgeries and treatment processes are not overly complex or challenging, and with a hospital adept at addressing the various causes of dark circles, effective treatment can be achieved easily. The recovery period is also short, making it a feasible option for those facing multiple causes of dark circles.

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