Miso Clinic · Clinical column

Lines around and under the eyes in Daegu — treatments that are safe to use and those to avoid

The eye area is where the dermis is thinnest on the face. Tiny differences show up large as shadow and show-through, and treatments that are fine elsewhere become a problem here. So we first separate what can be used around the eyes from what Miso Clinic does not use.

Clinical column About 5 min September 2026 Miso Clinic, Daegu · Dr. Lee Chi-Hak, Medical Director

The short answer

Around and under the eyes, we divide the concern into fine lines, hollows (the groove) and colour before choosing a treatment. For fine lines in thin skin we consider dermal injections such as finely particulate hADM (CellREDM) or PN (Rejuran); for the shadow of an under-eye groove we consider placing hyaluronic acid filler, which has the strongest data, at a deep level. CaHA (DCLASSY · Radiesse), which cannot be dissolved, is not used under the eyes because nodules form readily there. A review found that under-eye filler placed on the periosteum caused almost no bluish show-through while more superficial planes exceeded 30%, so in this area depth matters more than the product.

Eye-area concerns fall into three groups

Types of concern around and under the eyes
ConcernWhat it looks likeApproach that fits
Fine lines · thin textureFine lines that stay without smiling; dullnessDermal injections — CellREDM · Rejuran
Hollows · groove (shadow)A tired-looking under-eye groove that changes with the direction of lightHA filler placed deep
Dark colour (dark circles)Brownish, bluish or mixedBy cause — often not solved by injection alone
Lines that form when smilingDeepen with expressionThe territory of botulinum toxin

Dark circles mostly have more than one cause. In a study that classified 65 people, including by ultrasound, 5% were pigmented, 14% vascular, 3% structural (shadow) and 78% mixed. This is why Miso Clinic shines light from several directions and looks sitting and lying down — shadow changes with posture and lighting, pigment does not.

For fine lines — injections suited to thin skin

For fine lines around the eyes, dermal injections with no particles or fine particles are the direction that fits. Putting a product with large particles, or one that pools in one spot, into thin dermis shows directly as clumping or show-through.

Fine lines around the eyes — injection classes (clinical judgement)
ClassJudgement around the eyesEvidence and limits
CellREDM (hADM)Consider firstFine particles of about 75 μm designed to reduce injection resistance and clumping. No published human clinical study found
Rejuran (PN)ConsiderAddresses the environment without creating volume. There is 2026 literature on HA and PN under the eyes
BYRYZN (cross-linked HA)With cautionToo shallow and it causes the Tyndall effect (bluish show-through) — though it can be reversed
GOURI (PCL)Depends on the areaEye-area data are checked separately on the product page and at consultation
CaHANot usedAn area prone to nodules; no dissolving agent

For the under-eye groove — filler and depth

For the shadow of an under-eye groove, hyaluronic acid filler has the strongest data. In a review of 23 studies and 2,048 patients, satisfaction was 85–90%. The most important practical rule is depth — in a review of 830 patients, the Tyndall effect (bluish show-through) was almost absent when filler was placed on the periosteum and exceeded 30% in more superficial planes.

Korean data differ from Western data. CT in white populations showed the orbit widening with age, but in 3D CT of 107 Koreans the height and area of the orbital aperture did not change significantly. The explanation “bone melts away with age, so it hollows” is hard to carry over as it is; we take the shift in position of the fat compartments to play a relatively larger part, and decide from that where to fill and where to leave.

Signs to tell us about immediately. Severe pain during or right after injection, skin turning white or purplish, or any change in vision are rare but can be signs of a vascular complication. Time matters, so tell us at once.

How to choose by eye-area concern

Around and under the eyes — treatment considered first by concern (clinical judgement)
ConcernConsider firstAvoid
Thin fine lines and texture around the eyesCellREDM or RejuranCaHA
Shadow of the under-eye grooveHA filler placed deepCaHA; shallow injection
Eye lines that deepen when smilingBotulinum toxinExpecting boosters alone to solve it
Brownish dark circlesDiscuss pigment treatmentExpecting filler alone to solve it
Under-eye fat bulging forwardInclude a surgical consultationSimply covering it with filler

Which treatment is right is decided not by the product but by what is the main cause around your eyes now.

Summary

What is established

  • Classification of dark circles in 65 people: mixed 78%, single type 22%
  • Under-eye HA filler, 23 studies · 2,048 patients, satisfaction 85–90%; Tyndall effect almost zero with supraperiosteal injection (review of 830)
  • In CT of 107 Koreans, no significant change in orbital aperture height or area

What we could not find

  • A published human clinical study of CellREDM itself
  • A direct comparison between eye-area boosters
  • The primary source of the commonly quoted figure “eyelid skin is 0.5 mm”

Lines around and under the eyes in Daegu: frequently asked questions

Will a skin booster fill under-eye hollows?

Skin boosters are not volume-filling treatments, so they do not fill the shadow of a groove. For the under-eye groove we first consider placing hyaluronic acid filler, which has the strongest data, at a deep level.

Can Radiesse or DCLASSY be used under the eyes?

Miso Clinic does not use CaHA under the eyes. Nodules form readily in this area, and there is no agent that dissolves CaHA.

Why does it look bluish after under-eye filler?

It is the Tyndall effect, where hyaluronic acid placed too shallowly scatters light. In a review of 830 patients, supraperiosteal injection caused almost none, while more superficial planes exceeded 30%. If it happens, it can be reversed with hyaluronidase.

Can injections get rid of dark circles?

Dark circles usually have mixed causes (78% mixed in one study), so a single injection often does not solve them. The shadow component is approached with filling treatment, and the pigment component with other treatment.

For fine lines around the eyes, is CellREDM or Rejuran better?

No study has compared the two directly around the eyes. CellREDM supplies material with fine particles suited to thin areas, while Rejuran addresses the recovery environment; we decide by skin thickness and sensitivity.

Read next

Product pages

Related product references: CellREDM · Rejuran · BYRYZN

Who wrote this

Written and reviewed by Lee Chi-Hak, MD, medical director of Miso Clinic in Daegu, South Korea. Every study cited above is given together with its design, its size and the limitations the authors themselves recorded, and where we could not find data, we have said that we could not find any.

Miso Clinic
Medical directorLee Chi-Hak, MD
Address4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station
Phone+82-53-428-2700
HoursWeekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays
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References

  1. Types of dark circles — Huang YL et al., Int J Dermatol 2014;53(2):164. Classification of 65 people — pigmented 5% · vascular 14% · structural 3% · mixed 78%.
  2. Under-eye filler evidence — review of 23 studies · 2,048 patients (satisfaction 85–90%) · review of 830 patients (Tyndall effect almost zero with supraperiosteal injection, over 30% in more superficial planes) · 3D CT of 107 Koreans (Jeon A et al., Surg Radiol Anat 2020;42(5):617 — no significant change in orbital aperture height or area).
  3. HA and PN under the eyes — Hyaluronic Acid Fillers Versus Polynucleotides for Under-Eye Rejuvenation, Journal of Clinical Medicine 2026. Literature on the indications and limits of use around the eyes.
  4. CellREDM product information — manufactured by Hans Biomed (Korean distribution rights: Hugel). hADM microparticles of about 75 μm (manufacturer figure). We could not find any published human clinical study of CellREDM itself.
  5. CaHA safety — Safety of Calcium Hydroxylapatite: A Review (2017), analysis of adverse events across 5,081 treatments — nodules were the most common. Management of Nodules Following CaHA Injection, Aesthetic Surgery Journal 2024 — stepwise management. No agent exists that dissolves CaHA.
  6. Miso Clinic clinical protocols — criteria for indications, design by area, and the explanation and consent process before treatment. The source of the sentences marked “clinical judgement” in this column.

Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.

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