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Face Treatment

EyeArt® Method (Tear Trough Fillers)

CAUSES OF TIRED-LOOKING EYES AND DARK EYE CIRCLES

The tear trough lies between your lower eyelid and upper cheek. Early signs of ageing point toward the hollowing of the tear trough. As one ages, the tear trough area appears hollower, deeper, and darker, causing unattractive dark shadowing and eye bags to appear, making one look exhausted and aged.

Ageing

As we age, volume loss under the eyes can result in the formation of a "tear trough" – a noticeable depression beneath the eyes that casts shadows.

Skin Laxity

Our skin produces less collagen as we get older, leading to a weaker support system. This can make blood vessels, volume loss, and dark shadows more noticeable under the eyes, forming what's known as the "tear trough."

Sleep Deprivation

Lack of sleep may create paler, more translucent skin, which illuminates the blood vessels under the eyes.

This is the most common.

Smoking

Causes vascular problems and constricts the blood vessels. This results in poor circulation, making the blood vessels appear darker and more prominent.

Caffeine & Alcohol

Excessive caffeine and alcohol will result in dehydration, causing blood vessels to become swollen. Poor nutrition can also worsen dark eye circles.

Others

Nasal congestion and allergies can cause under-eye blood vessel inflammation. Sun exposure and eye rubbing lead to excess melanin production, resulting in visible engorged blood vessels and discolouration.

Weight Loss

Substantial weight loss can accentuate the visibility of under-eye bags and hollowness.

Genetics

While ageing contributes significantly to this concern, it's worth noting that some individuals may develop tear troughs as a natural facial feature, even from a young age.

WHAT CAN I DO ABOUT MY TIRED-LOOKING EYES AND DARK EYE CIRCLES?

An effective treatment at Amaris B. Clinic to treat tired-looking eyes, dark eye circles, fine lines, loss of volume under the eye, and poor skin quality is tear trough fillers with Dr Ivan Puah's proprietary approach, the EyeArt® Method.

The EyeArt® Method involves injecting hyaluronic acid-based (HA) dermal fillers at strategic points and depths into specific areas around the eyes to fill up loss volume and to lift and support the area. It will also address the appearance of dark lower eye circles, and help you look less tired, more rejuvenated and youthful.

WHAT TYPE OF DERMAL FILLERS DO YOU USE?

Only hyaluronic-based (HA) dermal fillers are used in the EyeArt® Method by Dr Ivan Puah. Once injected, it acts as a cushion, supporting facial structures and tissues that may have lost volume and elasticity. The product instantly fills the skin.

Hyaluronic acid

In your body, hyaluronic acid fills the spaces between cells, protecting them by retaining water and serving as a sponge.

Considered a "natural moisturiser" hyaluronic acid performs different bodily tasks. For instance, it helps maintain healthy joint cushioning and hydrates the connective tissue. Hyaluronic acid can hold up to 1,000 times its weight in water, keeping our skin's smoothness (moisturising effect) and plumpness (volumising effect).

During the ageing process, the production of hyaluronic acid naturally decreases. The skin becomes drier, and its ability to retain moisture and maintain elasticity depletes. Today, the signs and symptoms of the skin's natural ageing process can be reduced by replacing the lost hyaluronic acid.

I heard there are many dermal fillers available. Which one does Amaris B. Clinic use?

There are many dermal fillers that medical practitioners offer in Singapore, such as Belotero [1], [2], [3], Juvederm [4], [6], [7], [8], [9], Restylane [5], [10] [11], [12], Voluma[13], [14], [15]. Each of these has its own characteristics and indicated purposes. For example, Belotero and Restylane Silk are used to correct shallow and fine facial lines, while Voluma is recommended for cheek enhancement.

Does Amaris B. Clinic use FDA and HSA-approved HA dermal fillers?

As responsible healthcare providers, we prioritise the safety and well-being of our patients. We believe in using dermal fillers that have received approval from reputable regulatory bodies like the FDA and HSA. Our approach is guided by a commitment to quality, which includes products with proven efficacy and safety, backed by clinical studies.

DR IVAN PUAH'S EYEART® METHOD

Eye bags

Multi-layering

For an even and natural rejuvenation around the eye area.

Micro-droplet

Using very fine blunt cannulas instead of needles and his micro-droplet technique to reduce the risks of bruising and swelling.

Multi-dimensional

Through a multi-dimensional approach – lift the skin around the eyes, improve fine lines, and lighten dark eye circles.

What should I expect before the tear trough fillers treatment?

A detailed consultation will take place with Dr Ivan Puah to assess your clinical condition and to ensure that your expectations are understood. He will explain how to administer your treatment and address your concerns.

During the tear trough fillers injection, he will inject selected hyaluronic acid-based dermal fillers [16] into the tear trough area with his EyeArt® Method. Through his careful and strategic placement of the injection, he can lift and support the skin around the tear trough, fill up and smooth out hollowness.

When can I see the results?

Results and improvements will be noticeable immediately, but allow 7 to 14 days for any minor side effects, such as bruising or swelling (if any), to dissipate.

WHO CAN PERFORM EYEART® METHOD (TEAR TROUGH FILLERS) IN SINGAPORE?

Tear Trough Filler is marked as a medical device In Singapore under HSA regulation. Treatments such as dermal filler (including tear trough filler), injectable neurotoxins, and BioRemodelling HA+ Injection can only be prescribed and carried out by registered and trained medical doctors in Singapore.

Dr Ivan Puah

Dr Ivan Puah, the Medical Director of Amaris B. Clinic, holds a Graduate Diploma in Family Dermatology from NUS and boasts over 17 years of clinical experience in addressing various dermatological concerns. His proficiency encompasses the treatment of skin laxity, wrinkles, fine lines, hyperpigmentation, acne scarring, and more.

Dr Puah's knowledge and skill are further acknowledged through his appointment as a trainer-to-doctor by Merz Singapore and Allergan Singapore.

Dr Ivan Puah Dermal filler and botulinum toxin injections

Our Awards

EYEART® METHOD (TEAR TROUGH FILLERS) FAQS

How long does the EyeArt® Method (Tear Trough Fillers) take?

The treatment may take 30 minutes. You will most likely be able to continue your daily activities as soon as your appointment is over.

Does the EyeArt® Method (Tear Trough Fillers) hurt?

Nearly all our hyaluronic acid fillers are available with lidocaine to maximise your treatment comfort. The discomfort level is minimal.

What should I expect before the tear trough fillers treatment?

A detailed consultation will take place with Dr Ivan Puah to assess your clinical condition and to ensure that your expectations are understood. He will explain how to administer your treatment and address your concerns.

Reference

[1] Prasetyo AD, Prager W, Rubin MG, Moretti EA, Nikolis A. Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review. Clin Cosmet Investig Dermatol. 2016 Sep 8;9:257-80. DOI: 10.2147/CCID.S106551. PMID: 27660479; PMCID: PMC5021061.

[2] Lorenc, Z. Paul M.D.; Fagien, Steven M.D.; Flynn, Timothy C. M.D.; Waldorf, Heidi A. M.D.. Clinical Application and Assessment of Belotero: A Roundtable Discussion. Plastic and Reconstructive Surgery 132(4S-2):p 69S-76S, October 2013. | DOI: 10.1097/PRS.0b013e31829a0bfc

[3] Sundaram, Hema M.D.; Cassuto, Daniel M.D.. Biophysical Characteristics of Hyaluronic Acid Soft-Tissue Fillers and Their Relevance to Aesthetic Applications. Plastic and Reconstructive Surgery 132(4S-2):p 5S-21S, October 2013. | DOI: 10.1097/PRS.0b013e31829d1d40

[4] [5] Flynn, Timothy Corcoran M.D.; Thompson, David H. Ph.D.; Hyun, Seok-Hee Ph.D.. Molecular Weight Analyses and Enzymatic Degradation Profiles of the Soft-Tissue Fillers Belotero Balance, Restylane, and Juvéderm Ultra. Plastic and Reconstructive Surgery 132(4S-2):p 22S-32S, October 2013. | DOI: 10.1097/PRS.0b013e31829e88a3

[6] Lupo, Mary P. M.D.; Smith, Stacy R. M.D.; Thomas, Jane A. A.A.S, C.C.R.A.; Murphy, Diane K. M.B.A.; Beddingfield, Frederick C. III, M.D., Ph.D.. Effectiveness of Juvéderm Ultra Plus Dermal Filler in the Treatment of Severe Nasolabial Folds. Plastic and Reconstructive Surgery 121(1):p 289-297, January 2008. | DOI: 10.1097/01.prs.0000294968.76862.83

[7] Bogdan Allemann I, Baumann L. Hyaluronic Acid Gel (Juvéderm) Preparations In The Treatment Of Facial Wrinkles And Folds. Clin Interv Aging. 2008;3(4):629-34. DOI: 10.2147/cia.s3118. PMID: 19281055; PMCID: PMC2682392.

[8] Wolfgang G. Philipp-Dormston, David Eccleston, Koenraad De Boulle, Said Hilton, Helga Van Den Elzen & Myooran Nathan (2014) A Prospective, Observational Study Of The Volumising Effect Of Open-Label Aesthetic Use Of Juvéderm® Voluma® With Lidocaine In Mid-Face Area, Journal Of Cosmetic And Laser Therapy, 16:4, 171-179, DOI: 10.3109/14764172.2014.910079

[9] Li D, Xie Y, Li Q, Sun J, Jiang P, Jia Y, Murphy Dk, Li Q. Safety And Effectiveness Of Juvéderm Ultra Plus Injectable Gel In Correcting Severe Nasolabial Folds In Chinese Subjects. Plast Reconstr Surg Glob Open. 2017 Jan 16;5(1):E1133. DOI: 10.1097/GOX.0000000000001133. PMID: 28203492; PMCID: PMC5293290.

[10] Yan, Xiaoqing M.D.; Xu, Jun M.D.; Lu, Changsheng M.D.; Ma, Yongguang M.D.; Li, Wei M.D.. A Multicenter Study Of The Efficacy And Safety Of Restylane In The Treatment Of Nasolabial Folds In China. Plastic And Reconstructive Surgery 124(5):P 256e-257e, November 2009. | DOI: 10.1097/PRS.0b013e3181b98cbb

[11] Percec I, Bertucci V, Solish N, Wagner T, Nogueira A, Mashburn J. An Objective, Quantitative, Dynamic Assessment Of Hyaluronic Acid Fillers That Adapt To Facial Movement. Plast Reconstr Surg. 2020 Feb;145(2):295e-305e. DOI: 10.1097/PRS.0000000000006461. PMID: 31985621; PMCID: PMC7004449.

[12] Wu, Y., Sun, N., Xu, Y. Et Al. Clinical Comparison Between Two Hyaluronic Acid-Derived Fillers In The Treatment Of Nasolabial Folds In Chinese Subjects: Biohyalux Versus Restylane. Arch Dermatol Res 308, 145–151 (2016). https://doi.org/10.1007/s00403-016-1630-2

[13] Ho D, Jagdeo J. Voluma: A Systematic Review Of Clinical Experience. Journal Of Drugs In Dermatology : JDD. 2015 Sep;14(9):934-940. PMID: 26355610.

[14] Li D, Wang X, Wu Y, Sun J, Li Q, Guo S, Jia Y, Murphy Dk. A Randomized, Controlled, Multicenter Study Of Juvéderm Voluma For Enhancement Of Malar Volume In Chinese Subjects. Plast Reconstr Surg. 2017 Jun;139(6):1250e-1259e. DOI: 10.1097/PRS.0000000000003355. PMID: 28538556; PMCID: PMC5444429.

[15] Callan P, Goodman Gj, Carlisle I, Liew S, Muzikants P, Scamp T, Halstead Mb, Rogers Jd. Efficacy And Safety Of A Hyaluronic Acid Filler In Subjects Treated For Correction Of Midface Volume Deficiency: A 24 Month Study. Clin Cosmet Investig Dermatol. 2013 Mar 20;6:81-9. DOI: 10.2147/CCID.S40581. PMID: 23687448; PMCID: PMC3610404.

[16] Gold Mh. Use Of Hyaluronic Acid Fillers For The Treatment Of The Aging Face. Clin Interv Aging. 2007;2(3):369-76. DOI: 10.2147/cia.s1244. PMID: 18044187; PMCID: PMC2685277.

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