The treatment of debuting Sunken Cercles also called debuting Dark Cercles consists of a hyaluronic acid filling of very low abundance, in depth, underneath orbicularis muscle against the periosteum.
I utilise a 32G cannula or needle;
I inject a hyaluronic acid of latest generation, my preference goes evidently to Juvederm Volbella of Allergan or Redensity 2 of Teoxane.
If the debuting Sunken Cercles is very marqued, I recommand lipostructure if the patient agrees and can afford a few days of downtime.
Liposculpture of Sunken Cercles is to fill the hollow with fat taken from the patient.
But the treatment of Debuting Sunken Cercles (debuting Dark Cercles) is essentially in prevention.
The prevention starts early around the age of 30 when the repeated contractions of the upper beam of the malar orbicularis muscle of the eye (pars superioris orbicularis malaris oculi) chasing the underlying fat are beginning to result in a visible hollow.
At this point injections of Botox (botulinum toxin) expertly administered in very specific points are the real therapeutic approach.