Under-eyes and Tear Troughs

The under-eye area is often the first area where changes become noticeable over time, as it's the thinnest skin on the face. The natural anatomical groove under the eye, which contributes to the transition between the lower eyelid and cheek, is referred to as the tear trough. Changes in skin quality, lines, and darkness due to hollowing and shadowing of the under-eye area over time can be influenced by a combination of skin characteristics, underlying structure, and natural ageing processes.

An under-eye consultation at MD Cosmetic Nurse focuses on assessing your individual under-eye anatomy, skin quality, depth of the tear trough, dark circles and puffiness, and support from the mid-face volume and structure for natural-looking outcomes. Aesthetic ultrasound may be used to 'vascular map' and identify relevant arteries.

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Anatomical diagram of the under-eye area showing skin, fat compartments, obicularis oculi muscle, and underlying bone structure.

Anatomy of the under-eye

The under-eye area is made up of several anatomical structures, including the skin, fat compartments, ligaments, muscle and underlying bone.

The skin is thinner compared to other ares on the face, allowing underlying vascular structures to be more visible, which can contribute to the appearance of dark under-eye circles.

The obicularis oculi muscle surrounds the eye and plays a key role in facial expression when smiling.

Fat pads support the lower eyelids and help maintain a smooth transition between the lower eyelid and cheek. Changes in the position or prominence of these fat pads over time may influence the appearance of under-eye hollows or fullness.

The underlying bone structure contributes to overall shape and support of the under eye area. Bone resorption may change structural support over time.

Together, these structures influence the appearance of the under-eye area and how it may change over time.

How Skin Changes may influence the under-eye area

The skin beneath the eyes in thinner and more delicate than other areas of the face. Over time, reduced collagen and elastin production can affect skin firmness and elasticity, contributing to fine lines and changes in texture.

Because of its thin structure, this area may also reflect underlying changes more visibly than other areas of the face.

Structural Support and Volume Changes

The under-eye area is supported by a combination of fat compartments, connective tissue, ligaments and bone. Gradual changes in these structures can influence how this area appears, sometimes contributing to hollowing or shadowing.

These changes are often associated alongside broader facial structure and volume changes during a consultation.

Muscle Activity Around the Eye

The obicularis oculi muscle surrounds the eye and is responsible for movements such as smiling and squinting. Over time, repeated muscle activity can contribute to the development of lines in the surrounding area.

Learn more about how movement affects lines around the eyes.

Relationship to Surrounding Structures

The under-eye area is closely connected to the cheeks and mid-face. Changes in these surrounding structures may influence how the under-eye area appears.

Factors that may influence the appearance of the under-eyes

A range of factors may influence how the under-eye area appears, including genetics, sleep patterns, and environmental exposure. Other factors can include the broader part of facial aging.

Differences in pigmentation, skin thickness, and shadowing can contribute to the appearance of dark circles. You can learn more about this in our article on dark circles.

How the under-eye is assessed

An under-eye consultation at MD Cosmetic Nurse focuses on assessing your individual anatomy, skin quality, depth of tear trough, dark circles, puffiness, and support from mid-face volume and structure. During some consultations, aesthetic ultrasound is used to 'vascular map' and identify relevant arteries. Rather than a standard approach, each consultation begins with a thorough facial assessment to understand your unique anatomy and what your under-eye concerns are. Consultations may include consideration of skin quality, facial structure, and wrinkle formation, depending on individual concerns.

Common concerns discussed during an under-eye consultation include:

• Loss of volume over time causing a tear trough
• Asymmetry between sides
• Hollowness causing shadowing
• Skin quality
• Eye puffiness
• The cause of dark circles
• Support from the mid-face
• Natural-looking enhancement that complements your features

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Why choose MD Cosmetic Nurse for an under-eye consultation

Choosing the right practitioner for your aesthetic consultation is an important decision. All assessments at MD Cosmetic Nurse are tailored to each individual, and are consultation-led. This means your individual concerns, anatomy, and goals are discussed in detail before any treatment is considered. Michelle is centred on professionalism, ethical, evidence-based practice, and patient safety.

• Experienced registered nurse with over 12 years experience performing aesthetic procedures.
• Master of Nursing with a year-long capstone project on complications with aesthetic procedures.
• A natural-looking, balanced approach for subtle outcomes.
• Aesthetic ultrasound use in select consultations to provide insight for your individual anatomy.
• Consultations are conducted in professional, medical clinical environments inside specialist plastic surgeon-owned clinics in Surry Hills and Mosman, as well as Penrith.

Book a consultation for a detailed facial assessment to determine suitability for your individual goals. Individual results vary from person-to-person and from treatment-to-treatment. A consultation is required and does not guarantee treatment.

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Frequently Asked Questions

The tear trough is a natural anatomical feature located between the lower eyelid and the upper cheek. It appears as a groove or hollow and plays a role in how the under-eye area transitions into the cheek.

Under-eye wrinkles can develop due to a combination of thin skin, reduced collagen and elastin, and repeated muscle movement over time.

Hollows may become more visible due to gradual changes in fat pad size and position, and structural support in the area.

Dark circles may be influenced by hyperpigmentation, skin thickness, visible vascular structures, hollowing and shadowing and individual anatomical differences.

Yes, the skin is thinner and more delicate, making it more prone to visible changes of fine lines and textural changes over time.