Purpose: To evaluate the results of patients with complaint of under eye hollowness and dark circles and application of under eye
hyaluronic acid filler, comparison of the cannula and injection techniques.
Method: Under eye hyaluronic acid filler was applied to the patients who consult to the clinic with complaint of hollows and dark
circles under eye between March 2014 and December 2016. Application method was evaluated according to the success of results,
satisfaction and complications.
Findings: 356 eyes of 178 patients were included to the research. There were 148 (83%) female and 30 (17%) male patients. Average
age was 33 (age range 19 - 60). It was defined that the most frequently complaint was under eye hollowness with 84% and followed
by dark circles with 74%. It is seen that in over 40 year old patients, the most common complaint was dark circles with 80%.
The filler was applied to 140 patients with cannula and to 38 patients with injection. The hyaluronic acid filler was implemented
0,83ml (0,4 - 1,25ml) total for each eye approximately. Patients were followed averagely 14 month (1 - 32 month). While the most frequent
complication was ecchymosis in 14 patients (8%), the second one was edema which lasts over two weeks in 8 patients. Emboli
was not seen in any patient. When the cannula and injection techniques were compared, a distinct difference was seen in terms of
ecchymosis risk. The risk of ecchymosis was 3% with usage of cannula, whereas with needle, it was 26%. Besides, while ecchymosis
caused by injection was seen in more extensive area, the area caused by cannula was more limited. As satisfaction evaluation, 93%
patients graded the filler application as good. 5% patients thought that it was average and 2% of them scored it as bad. 4 patients who
evaluated the application bad were the ones that their filler was applied with injection and occurred ecchymosis in their under eye.
Result: The procedure of hyaluronic acid filler is an alternative treatment in the patients who have dark circles and hollows under
eye. The procedure with cannula technique is safer for the patience satisfaction and risks of application, but this technique should be
used with experienced doctor.