Concern
Hollows and shadows under the eyes
The most common request here, and the one where the answer is most often no. Under-eye shadow has at least four causes and filler helps exactly one of them.
Four different problems
that look identical in a mirror
Which one you have decides whether anything here helps at all.
- A true hollow — the ligament tethers the skin and the fat above has descended, leaving a groove. This is the one filler addresses
- A fat pad bulging forward, which reads as a shadow above it. Adding filler to this makes it worse
- Pigmentation in thin skin, often constitutional and often familial. Volume does nothing to a colour
- Skin so thin the underlying muscle shows through blue. Filler placed into this is visible as a lump or a grey cast
- Fluid, which changes hour to hour and with sleep, salt and allergy — and is not a structural problem at all
Realistic options
Read the first one carefully. It applies to a large share of the people who ask, and it is the request we most often turn down at the North Vancouver clinic. The assessment is worth booking even when the answer turns out to be no.
- No treatment needed
Nothing here will help
If the cause is pigment, fluid, or a bulging fat pad, filler is either useless or actively makes it worse. We would rather tell you that at the assessment than take the booking.
For pigment, a dermatologist is the right referral and we will say so. For a bulging pad, that is a surgical question — the clinic across the hall.
- Skin & body
Dermal filler, if it is a true hollow
A small amount, deep, on bone, in a plane chosen to avoid the vessels that run there. This is the least forgiving area on the face and the one where restraint matters most.
- Downtime
- Bruising is common here and can last a week
- Typically lasts
- 9–18 months
- Surgery
Surgical assessment for the fat pad
Where the problem is a pad that has come forward rather than a groove, repositioning or removing it is a lower-eyelid operation, not an injection.
- Downtime
- Discussed at consultation
- Typically lasts
- Long-term
This is the region where injectable complications are most serious, because the vessels here connect to the eye. That is a reason to care who injects it and how much, not a reason to avoid it.
What people ask
Can you just fill them a bit?
Sometimes, and often no. The examination is a one-minute test of whether the shadow is a groove, a pad, a colour, or fluid — and the answer changes the recommendation completely.
Will it fix my dark circles?
If the darkness is a shadow cast by a hollow, improving the hollow improves the shadow. If the darkness is pigment in the skin, nothing injected under it changes the colour. Those are two different findings and you should be told which you have.
Why does everyone say this area is risky?
The vessels here communicate with the retinal circulation, so material injected into one has somewhere serious to go. It is rare and it is the reason for the technique, the product choice and the volume being conservative.
It looked lumpy on a friend. Why?
Usually product placed too superficially in skin too thin to hide it. Hyaluronic acid can be dissolved, which is why we use it here rather than anything permanent.
How long does bruising under the eyes last?
Bruising is common here — the skin is thin and the vessels sit close under it — and generally takes about a week to clear, sometimes longer, with two to three days of swelling on top of that. For that reason people booking around a fixed date are generally told to leave at least two weeks. Makeup over a settled bruise is fine from the following day.
Bring the shadow
Ask usWho does this
Assessments and treatments at the Lonsdale Avenue clinic in North Vancouver are carried out by MMC’s own clinicians. Who they are, what they trained in and which treatments each of them does is on the team page.
Other places people start
These are sorted by what is bothering you rather than by treatment name. Each page says what actually helps, what does not, and when the honest answer is that nothing here is needed.
- Loose Skin After Weight LossLosing the weight is the hard part and you have done it. What is left is usually a skin problem rather than a fat problem, and those have completely different answers.
- Fatigue & Low EnergyThis is the concern where we are least likely to sell you anything, and we would rather say that at the top of the page than at the end of a consultation.
- Dullness & Uneven ToneDullness and dehydration are a texture problem, not a shape problem. That distinction decides which half of the menu is even relevant.
- Volume Loss & HollowsVolume loss is the change people describe as looking tired or gaunt without being able to name a line. It is also the one where over-treatment is most visible from across a room.
- Forehead & Frown LinesForehead and frown lines are muscle before they are skin. The question that decides your result is not the dose — it is whether the line is still only there when you move.
- Hooded Upper LidsThe line where this stops being an injectable question and becomes a surgical one is unusually clear, and you are entitled to be told which side of it you are on.
- Jawline & Contour LossThe most common reason people book here, and the one where the honest answer changes most with age. In your forties a device usually does it. In your sixties it usually does not.
- Nasolabial FoldsNasolabial folds are usually a symptom. Filling the fold itself is the most common way to end up looking heavy in the lower face.
- Stubborn Body FatA pocket that stays the same size while the rest of you changes. Usually the flanks, the lower abdomen, or under the chin. The useful question is not which machine to use — it is whether what you are looking at is fat at all.