Hollow or structural dark circles: what are the solutions?

The structural dark circles, or hollow dark circles, are identified by the appearance of a pronounced shadow under the eyes. The facial bone structure accentuates the hollow, making the orbital contours particularly visible. Genetically determined, this type of dark circles can also result from significant weight loss. Aging may also contribute, as it tends to thin the facial fat pads. It is important to understand that hollow under-eye circles are the most challenging to treat.

The hyaluronic acid injections are currently the method of choice for eliminating structural dark circles.

This technique restores volume to the periorbital area, thereby filling the hollow. The results it achieves are, however, temporary and last between 12 and 18 months. Several studies have demonstrated the benefits of hyaluronic acid injections for reducing the visibility of structural dark circles, including the study conducted by SPADA with 32 women presenting this type of dark circle. After the hyaluronic acid injection, they were followed for one year. Dermatological assessments showed the achievement of a natural result that was maintained throughout the 365 days of observation, although it was not quantified. The procedure was well tolerated; only one participant required an injection of hyaluronidase to neutralize the hyaluronic acid due to overcorrection.

For a permanent filling effect in structural tear troughs, it is necessary to turn to lipostructure, also known as lipofilling, a procedure that involves injecting fat cells harvested from other parts of the body into the periorbital area.

The objective is to reconstitute the fat pad of the tear trough. Although highly effective, it is important to note that lipostructure is an invasive technique performed under general anesthesia and requiring hospitalization, unlike hyaluronic acid injections, which can be performed directly in a physician’s office. Nevertheless, when performed by an experienced surgeon, this procedure carries relatively low risk. Only a slight asymmetry of the result may sometimes be observed, which can be corrected with a touch-up lipostructure.

Makeup won’t plump up your hollow under-eye circles, nor will a caffeine treatment. Instead, pay particular attention to hydrating this area with the eye contour cream, which is highly concentrated in coenzyme Q10. Also called ubiquinone, this naturally occurring coenzyme in the body stimulates cellular regeneration and helps prevent collagen breakdown and loss of skin elasticity. The coenzyme Q10 thus rejuvenates the eye area and helps prevent the formation of early fine lines. This formula also contains prickly pear oil, an ingredient with tightening and firming effects as well as antioxidant properties.

• BERTHEUIL N. & al. Eyelid fat grafting: Indications, operative technique and complications; a systematic review. Journal of Cranio-Maxillofacial Surgery (2016).

• LIU C. & al. Autologous fine particles fat filling under direct vision in the repair of sunken upper eyelid after double eyelid surgery. Aesthetic Plastic Surgery (2022).

• SPADA J. Treating sunken upper eyelid with hyaluronic acid: Recommendations and results. Journal of Drugs in Dermatology (2022).

• YI K.-H. & al. Anatomical-based filler injection diagnosis to treatment techniques: Infraorbital groove and hollowness. Life (2025).