Seoul forum breaks under-eye filler into three anatomical problems

At a Seoul aesthetics forum, Cliff Clinic’s Dr. Gunwoo Hong argued that dark circles and under-eye hollows are not one problem but three separate issues, and that each needs its own injection plan. The message matters because the wrong diagnosis can lead to unnatural results and higher patient complaints after filler treatment.

Why it matters: - Under-eye filler can go wrong when clinicians treat dark circles as a single issue instead of separating hollowing, skin laxity, and pigmentation. - Dr. Gunwoo Hong’s framework aims to improve natural-looking results and reduce complaints tied to overfilling and poor plane selection. - The approach has practical value for aesthetic doctors who work around the lower eyelid and midface, where small technique changes can affect outcomes.

What happened: - On August 26, Dr. Gunwoo Hong of Cliff Clinic in Gangnam, Seoul, spoke at the 7th Aesthetic Medicine Innovation Forum in Seoul. - The lecture was titled “Beyond the Tear Trough: Three Anatomical Structures Behind Under-Eye Hollowness.” - The forum was hosted by the Young Aesthetic Physicians Medical Society at BTQ Clinic. - Dr. Hong explained the anatomy behind dark circles and under-eye hollows to guide treatment planning.

The details: - Dr. Hong divided what patients call dark circles into three components: a depression along the under-eye grooves, reduced skin elasticity, and visible pigment in the skin. - The three components often overlap in the same patient. - Each component needs a different treatment approach. - Treating hollowing like pigment, or pigment like hollowing, can produce poor results. - Dr. Hong said adding volume without first identifying the cause can create unnatural results and trigger complaints about side effects. - The anatomical diagnosis should come before the treatment decision. - Dr. Hong said under-eye hollowness involves three grooves that should be assessed separately: the tear trough, the palpebromalar groove, and the midcheek groove. - Midcheek volume loss, including the suborbicularis oculi fat, contributes to the midcheek groove. - The three grooves sit at different depths over different tissues. - Injection plane, instrument choice, and filler properties should be matched to each groove instead of treating the area as one uniform site. - In case presentations, Dr. Hong used two Galderma products to apply that principle. - Restylane Original, described as highly cohesive, was placed in deeper planes for firm support and localized volume. - Restylane Defyne, described as more tissue-adaptable, was used in more superficial areas where the filler needed to spread evenly and move with facial expression. - In the live case presentation, Dr. Hong described site-specific injection strategies meant to reduce under-eye filler complications while creating a natural lifting effect. - Dr. Hong identified three habits that affect patient satisfaction: checking the result immediately after injection, molding the product carefully with a cotton swab, and avoiding overcorrection.

Between the lines: - The lecture reflects a broader shift in aesthetic medicine toward anatomy-first planning rather than one-product or one-plane treatment. - The focus on separate grooves suggests under-eye work is becoming more individualized, with technique tailored to tissue depth and movement. - The society’s response shows demand for practical, structure-by-structure guidance among physicians already doing periorbital procedures.

What's next: - The Young Aesthetic Physicians Medical Society said its Aesthetic Medicine Innovation Forum will continue sharing current clinical knowledge and techniques. - The framework Dr. Hong outlined is likely to influence how clinicians assess under-eye patients before choosing filler type, depth, and correction amount. - Cliff Clinic continues to offer consultations in English by the treating physician.

The bottom line: - Dr. Hong’s main message was simple: under-eye filler works best when doctors diagnose the exact cause of the problem first, then match the product and plane to the anatomy.