The best doctor for injecting gel under the eyes in Moghadis Ardabili; The best way to remove dimples and darkness, Dr. Vida Shakiba

. Why does the area under the eyes become hollow and dark? (Knowing the exact anatomy of aging and rooting)

The area under the eyes (Tear Trough) is one of the most sensitive and complex parts of the face due to its very delicate anatomical structure. Due to the lack of sufficient supporting fat and direct proximity to bones, vessels, and ligaments, this area suffers signs of aging, fatigue, and sagging faster than other parts. Accurate understanding of aging mechanisms in this area is essential for successful treatment.

The main causes of dimples and darkness under the eyes: the difference between atrophy, displacement and ligament weakness

1. Bone analysis (Bone Resorption) and orbital retraction:

With increasing age,

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Darkness caused by pigmentation (melanin):

Brown darkness caused by excessive melanin production in this area. This type of darkness is usually hereditary and its treatment requires a combined approach (gel, mesogel, surface peelings, topical creams and laser).

2. Gel injection method under the eyes: absolute safety and specialized protocols

Filler injection in the area under the eyes is one of the most specialized and risky injections in cosmetic medicine. The risks caused by proximity to vital arteries require that this treatment be performed only by a physician with high anatomical skill and familiar with safety protocols.

a) The best method: injection of hyaluronic acid filler with a cannula and the technique of "lift from below"

It is necessary to use new generation hyaluronic acid (HA) fillers with the following special features:

• Low Swelling Capacity (Low Water Absorption): This feature is vital because the under-eye area is prone to long-term swelling due to the lack of a strong lymphatic network. The filler should have minimal water absorption to avoid post-treatment swelling that can create the appearance of permanent puffiness.
• Low G-Prime (Low Viscosity): To ensure softness, uniformity and no feeling of filler under the skin. The filler should adapt well to the delicate tissue of the eyelid.
• High Cohesivity (high adhesion): The filler must have strong adhesion so that it does not move or become a ball (nodule) against the movement of the eyelid.
• Cannula injection (Blunt Tip Cannula): This method is the safest and most standard global solution for injections under the eyes. A cannula is a tool with a round tip that does not tear vital vessels and push them aside.
  • Safety advantage and aspiration test: The risk of intravascular injection is greatly reduced. Before injection, the doctor performs an aspiration test by pulling the syringe back to make sure that the tip of the needle or cannula is not inside the vein. This is an unmissable safety protocol.
  • The advantage of the result: It is possible to distribute the filler evenly and superficially in the right layer (on the bone), which creates a natural result without bumps or unevenness.

b) The role of MD Codes in the safety and natural result under the eye

MD Codes considers the under eye area as a refinement code called Ck3 and emphasizes that the treatment should be structural:

1. Cheek structure repair (Ck1 and Ck2): First, the cheek bone supports are repaired. By injecting filler with high G-Prime in these deep points, a vertical lift is made from below and the hollow under the eyes is automatically reduced.
2. Finishing (Ck3): Only the small volume needed to eliminate the remaining dimple is injected directly into the lacrimal groove (Ck3). This approach reduces the need for high volume under the eyes and prevents over-correction (Over-Correction) which is the most common cause of dissatisfaction.

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3. Combined treatment of dimples and darkness: Mechanisms of correction of shade and skin quality

Successful treatment under the eyes in Moghadis Ardabili often requires a combined approach that addresses both volume defects and skin quality problems.

A) Fixing dimples and shadows with fillerHA (Geometric correction):

• Method: Injection of HA filler with a cannula in the periosteal layer.
• Mechanism: Filler under the skin smoothes the tissue and evens out the distance between the eyes and cheeks. This uniformity causes the light to be reflected uniformly instead of sinking into a hole and creating a black shadow, and the darkness caused by the shadow (the most common type of darkness) is eliminated.

b)

Pigmented darkness (Pigmented):

• Mesogels and Skin Boosters: Injection of mesogels (such as Jalpro or Prostalin) and Skin Boosters containing antioxidants, diluted hyaluronic acid and peptides to stimulate collagen production, deep hydration and gradual brightening of the skin. These materials also improve the appearance of fine lines.
• Local treatments: Recommendation of specialized creams containing weak retinol, vitamin C and peptides to reduce melanin production and cell renewal.

4. Why is a specialized clinic in Moghaddis Ardabili chosen for injections under the eyes? (Patient selection criteria and safety protocol)

Choosing a clinic at the level of Zafaranieh/Maqdis Ardabili guarantees compliance with the highest safety, anatomical and aesthetic protocols.

a) Accurate patient selection criteria (Patient Selection):

The doctor must first confirm the patient's candidacy.

• Ideal candidate (filler): Patients with a clear dimple (Grade I and II) without severe puffiness (Eyebag).
• Unsuitable candidates (referral to surgery): Patients with severe fat protrusion (grade III puff) who need eyelid surgery (blepharoplasty).
• Pinch Test (Pinch Test): The doctor evaluates the elasticity and thickness of the skin by gently pinching the skin under the eyes. If the skin is very thin, the filler should be injected with a very small volume to avoid complications.

b) comprehensive analysis and two-session protocol (staged correction):

Gel injection under the eyes often requires two sessions 2-4 weeks apart, which shows commitment to a natural and safe end result:

• First session (Build-up): Injecting a smaller volume than required to create an initial structural lift and observing the tissue reaction to the filler and the amount of water absorption.
• Second Session (Refinement): After the complete reduction of initial swelling (after 2 weeks), the remaining volume is injected to achieve the final result and perfectionism. This method reduces the risk of over-correction to zero.

C) Prevention of the Tyndall Effect

Tyndall effect is a common and unpleasant side effect of under eye injection, in which the filler appears blue/gray under the skin due to superficial injection or use of inappropriate filler.

• Mechanism of the complication: This effect occurs when the sunlight hits the filler particles in the very superficial layer of the skin and according to the law of physics (Rayleigh scattering), short wavelengths (blue) are scattered more than other colors, as a result the skin appears blue.
• Doctor's solution: Injection only in the periosteal layer (deepest layer), use of filler with homogeneous particles and appropriate size for the under eye area and cannula technique completely prevent this complication.

D) Management of pain and complications:

• Pain management: Use of strong anesthetic creams and, if needed, nerve block to maximize patient comfort during injection. Also, most under-eye fillers contain lidocaine (an anesthetic).
• Availability of hyaluronidase: In standard clinics, preparation is critical to manage potential complications. In case of any problems or dissatisfaction, Hyaluronidase must be immediately available to dissolve the filler. This enzyme absorbs the filler within a few hours and solves the problem.

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5. Care after injection and durability of results

Key care (Critical Aftercare):

• Cold compress and head position: Using cold compress for 24 hours. For a few nights, the head should be placed above the body to improve lymphatic drainage and reduce swelling.
• Avoid pressure and massage: Avoid massage or pressure on the injection area for 48 hours. Massage can lead to displacement of the filler in the wrong layer.
• Hydration: Drink plenty of water to stabilize the HA fillers.

Permanence and stabilization of results:

• Consolidation period: The result of the injection is changing up to 2 weeks after the injection, and the final result is determined in the repair session (second session).
• Permanence of under eye filler: 12 to 18 months. Due to less movement of the under eye area and injection in the deep layer on the bone, the filler usually has a high durability. However, the need for touch-up injections after 12 months is common to maintain the desired result.

6. Conclusion: return freshness to your eyes with complete safety and scientific approach

Injection of gel under the eyes is one of the most effective treatments to remove a tired, hollow and dark face, provided that it is done with deep anatomical knowledge, fillers specific to this area and modern safety techniques (such as cannula, MD Codes and two-session protocol). In our specialized clinic in the north of Tehran (Zaffaranieh/Moqds Ardabili branch), by using these specialized protocols, safety and natural beauty under your eyes are guaranteed.

Vida Shakiba Clinic

urgent consultation and whatsapp number: 09381855454

Address of North Tehran branch (Zafraniyeh/Moqds Ardabili):

Tehran, Zafaranieh, Ejazi St. (Asef), above Serah Asef, 33 Asef Building, No. 33, 2nd floor, Unit 7

(landline: 02126293055)

Address of West Tehran branch (Sadeghieh):

Tehran, 2nd floor of Sadeghieh, East Ferdous Boulevard, in front of Ferdous Cultural Center, No. 191, 5th floor, Unit 10

(landline: 02144003929)

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