Frequently Asked Questions About Dark Circles, Sagging, and Puffiness Under the Eyes

Removing too much fat from under the eyes can leave excess skin, making fine lines more noticeable. At YAYOI CLINIC, we follow the principle of “not removing too much, not cutting too much,” carefully assessing the amount of fat and the condition of the skin. As needed, we also consider the Hamra method—which involves repositioning fat—and injectable treatments, prioritizing a balance between fullness and the surrounding hollows.

At YAYOI CLINIC, we prioritize a natural appearance in our treatments for under-eye dark circles. We identify the causes of shadows by assessing the condition of your bone structure, muscles, and skin, and aim for changes that blend seamlessly with your current facial features. Please feel free to share any specific requests—such as “I’d like to avoid drastic changes”—during your consultation. Please note, however, that the final results may vary from person to person.

You don’t have to decide on surgery right away after your consultation for under-eye dark circles. At YAYOI CLINIC, we’ll listen to your concerns and wishes, and after a doctor examines the condition of the area under your eyes, we’ll explain your options, such as surgery or injectable treatments. We’re also happy to address any concerns you may have about surgery or to simply discuss your condition first.

Transconjunctival fat removal is a procedure that removes fat from under the eyes, while the Ura-Hamura method involves repositioning fat into hollows. Although both procedures are performed through an incision on the inner side of the lower eyelid, the most suitable method varies depending on the condition of the puffiness and hollows. At YAYOI CLINIC, we examine the eye area to determine the best treatment option. For more details, please see our page on treatments for under-eye sagging and dark circles.

Injection treatments are also an option for under-eye hollows. At YAYOI CLINIC, we use hyaluronic acid for mild hollows and also offer treatments using baby collagen to address dark circles and fine lines. However, since shadows under the eyes can sometimes be caused by fat bulges, we determine the cause through a consultation before selecting a treatment method.

The level of pain experienced during under-eye dark circle treatment varies depending on the procedure you choose. At YAYOI CLINIC, we use local anesthesia and take care to minimize pain and anxiety throughout the procedure. Since surgery may cause some pain afterward, be sure to confirm the type of anesthesia and the post-procedure recovery process in advance. If you’re concerned about pain, please let us know your preferences during your consultation.

The downtime for under-eye dark circle treatments varies depending on the procedure. After surgeries such as transconjunctival fat removal or the Hamra procedure, swelling and bruising may last for about 1 to 2 weeks; with the Hamra procedure, swelling may persist for about 4 weeks. Since it may take 1 to 3 months for the results to settle naturally, please consult your doctor and take your schedule into account.

The timing for resuming makeup after under-eye dark circle removal surgery depends on whether sutures need to be removed. At YAYOI CLINIC, you can apply makeup the day after the procedure if no sutures are required, or the day after the sutures are removed if sutures were used. Sutures are typically removed about one week after surgery, as needed. Please confirm the actual timing for resuming makeup based on the specific procedure you chose and your post-operative condition.

If you’re concerned about both dark circles and sagging under your eyes, it’s possible that bulging fat is casting a shadow. This is because, as you age, the tissues that support the fat weaken, causing the area under the eyes to bulge, and the shadow beneath it may appear as dark circles. In some cases, changes in facial volume can also make hollows more noticeable. At YAYOI CLINIC, we determine the cause of the shadow during your consultation.

Depending on the cause, dark circles and sagging under the eyes can sometimes be difficult to resolve with at-home care alone. For example, this includes cases where you’re concerned about shadows caused by bulging fat or hollows under the eyes. At YAYOI CLINIC, we examine the eye area and, depending on your condition, recommend treatments such as fat removal, the Hamra procedure, or injectable treatments. To determine which method is right for you, it’s important to identify the cause of the shadows.