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Dark eye circles, tear trough deformity and eye bags are common concerns that make a person look tired and older. Causes include: facial ageing process, facial volume loss, facial structure, nasal allergies, poor sleep and pigmentation. The standard treatment was to perform undereye fillers to address the volume loss and to inject skinboosters for skin hydration and brightening. Eye creams such as Skinceuticals A.G.E Eye Complex help to moisturise the delicate undereye skin.
For many years, the standard treatment solution was to inject hyaluronic acid fillers (“HA Fillers) into the undereye - this provided a quick, effective and no-downtime solution. By restoring the lost volume of the undereye, the hollowness and shadows of the sunken undereye area were improved. This generally worked well in 80-90% of the patients, with reasonably good results.
However, not everyone was happy with undereye HA fillers. Due to the hydrophilic (water-loving) nature of HA fillers, they had a tendency to draw in water and swell up, leading to undereye edema (puffiness) and a bluish discoloration known as the “Tyndall effect”. In the delicate, sensitive undereye area, even a tiny bit of fluid retention and swelling can be a big problem. US celebrity Jennifer Aniston found out the hard way when she attended a red carpet event in May 2024 with puffy and swollen undereyes, leading numerous media outlets and doctors to speculate that she had botched undereye fillers done (to this date , she has declined to comment).
HA fillers also had a tendency to migrate inferiorly (due to gravity) and collect along the tear trough ligament, worsening the issue of filler edema with bluish discoloration.
A typical patient’s experience would be that everything looks fine just after the undereye HA filler is performed, but a “lumpy blue sausage” of inferiorly migrated filler that has swollen up develops about 2-3 months later (and stays there a long time!)
For a detailed discussion of undereye filler pitfalls, read here
Another approach was to perform skinboosters such as rejuran eye or redensity one for the undereye area- the concept was to improve the skin quality of the undereye to “rejuvenate” the skin and reduce the appearance of dark eye circles, tear troughs and eye bags. Did it work? Maybe a little bit, from the improvements in skin quality. However, multiple treatments were required, often inconvenienced by bruising of the undereye due to the many small injections required. So, this approach did not gain much popularity.
The good thing about HA fillers is that when they are poorly performed or developed complications such as migration or swelling, they can be addressed with filler-dissolving hyaluronidase injections.
While that solved the problem of puffy undereyes, patients would end back at square one, with their dark eye circles and eye bags back with a vengeance (and their wallets significantly lighter)- not a happy situation!
Given the issues faced with HA filler injections to the undereye, many doctors and clinics are switching over to Deusaderm collagen injections for undereye rejuvenation. A purified collagen injection (containing porcine collagen), Deusaderm collagen injections provided immediate volume restoration with a natural look and feel. The whitish color of the collagen resulted in a “concealer effect”, lightening the undereye and improving the appearance of dark eye circles. The collagen integrated well with the skin and did not draw in fluid- meaning no migration, no edema, and no Tyndall's effect. As the collagen gradually breaks down to release amino acids and peptides, the undereye skin quality improves, becoming firmer and healthier.
Over the past 12 months I have treated a steady stream of patients with Deusaderm collagen injections to their undereye and the story is pretty much the same: they’ve had undereye fillers treatment before and it didn’t go too well, so they came to dissolve the undereye HA fillers and receive treatment with Deusaderm collagen injections.
Step 1: Dissolve migrated/swollen HA filler with hyaluronidase injections, and wait a week for swelling and bruising to go down
Step 2: initial Deusaderm collagen treatment (2-3 syringes)- patient satisfaction is typically high as the results can be quite dramatic
Step 3: 4-6 months later, perform touch-up Deusaderm treatment (1-2 syringes) for maintenance
There is no downtime from these treatments, and patients may return to normal activity right away
Deusaderm collagen is produced by Sunmax Biotechnology in Taiwan and has been in use for over 10 years. The source of collagen is porcine (ie Pigskin), which has a 99.9% similarity to human collagen; hence, it integrates well into human skin. So the old folks were right, and eating pigskin is good for your skin after all! Deusaderm collagen has been approved for medical use in Singapore, and thankfully, filler complications such as infection, vascular occlusion, nodules, and granuloma have not been reported
While generally safe, expect mild swelling for 1-2 weeks after Deusaderm collagen injections.
In severe cases where the collagen accumulates and becomes lumpy, it may be broken down with radiofrequency-based energy-based devices.
Injected collagen undergoes natural degradation over 4-6 months, so any lumps will eventually disappear with time.
$988 nett (1 syringe- 1cc)
Deusaderm collagen injections represent a new hope in the treatment of dark eye circles, tear trough and eye bags- avoiding the common pitfalls associated with undereye HA fillers and giving natural-looking cosmetic outcomes.
