Dark circles don’t always fade with rest or creams. For many patients in Honolulu, under-eye shadows are rooted in structural changes, like volume loss, fat displacement, or inherited pigmentation. At True Vision Center Hawaii, Dr. Melanie Tantisira addresses these concerns with precise dark circle treatment designed to restore brightness and balance to the eye area.

What Causes Dark Circles?

The under-eye area is thin, delicate, and prone to showing changes faster than the rest of the face. Common causes of dark circles include:

  • Genetics: Some patients are born with thinner skin or more pigment under the eyes, especially in families with naturally darker complexions.
  • Aging: Collagen and fat loss deepen the tear trough, creating shadows that make you look more tired than you are.
  • Fat pad displacement: With age, the fat that once supported the eyes can shift or bulge, casting shadows and creating puffiness or hollowness.
  • Allergies and inflammation: Frequent rubbing or seasonal allergies can lead to chronic under-eye discoloration.
  • Sun exposure: UV rays stimulate melanin, often darkening the sensitive eye area.
  • Lifestyle: Dehydration, poor diet, and inadequate sleep don’t cause the issue, but they can magnify it.

 
For those seeking a tired eyes treatment that delivers lasting results, pinpointing the cause is the first step. Dr. Tantisira takes the time to assess whether volume loss, pigmentation, skin laxity, or all three are contributing to the concern.

How Dark Circle Treatments Work

To correct hollowing and shadowing, Dr. Tantisira uses a refined filler technique involving hyaluronic acid dermal fillers. This brightening eye treatment is performed with a blunt-tipped cannula, allowing for safer, more even filler distribution along the orbital rim.

After applying a potent numbing cream and local anesthetic, a tiny entry point is made under the eye. Through that entry, the filler is gently threaded beneath the skin to smooth out depressions and restore natural-looking volume.

Patients can expect:

  • Immediate, visible improvement
  • Minimal downtime
  • Long-lasting results (typically 12 months or more)
  • Little to no bruising

 
This treatment works beautifully alongside procedures like the Madonna Lift, but it’s highly effective when skin tone and elasticity are still in good condition.

[Before & After Gallery]

Choosing the Right Solution for You

No two sets of eyes are the same, and under-eye filler should never be treated as a one-size-fits-all solution. Dr. Melanie Tantisira brings a rare combination of surgical skill and aesthetic judgment to this delicate area. With decades of experience as a board-certified ophthalmologist and cosmetic injector, she takes a thoughtful, customized approach to every treatment.

Here’s how she builds a plan that works with—not against—your natural features:

Step 1: Facial Structure Evaluation

Dark circles may appear in the same area on most people, but the underlying anatomy varies widely. Some patients have deep tear troughs, while others have prominent fat pads or uneven cheek volume. During your consultation, Dr. Tantisira evaluates how your bone structure, fat distribution, and skin elasticity interact to create shadows or puffiness.

This structural assessment is the foundation of a safe and effective treatment plan.

Step 2: Skin Quality and Texture Review

The thickness and tone of your under-eye skin matter. Thin, crepey skin might require a more conservative approach or benefit from pairing filler with skin-tightening options like the Madonna Lift. On the other hand, thicker skin with minor hollows may respond beautifully to a small amount of hyaluronic acid filler alone.

Step 3: Pigmentation vs. Shadow Distinction

Not all discoloration is caused by volume loss. Some dark circles are more related to pigmentation, especially in patients with a genetic tendency or a history of sun exposure. Dr. Tantisira will determine whether your darkness is due to shadows, pigment, or both. If pigmentation plays a major role, she may recommend additional treatments or skincare to target that directly.

This prevents overfilling and leads to more balanced, refined results.

Step 4: Treatment Plan Customization

Once the assessment is complete, Dr. Tantisira creates a personalized treatment plan. This could include under-eye filler, eyelid skin tightening, or a staged combination. She’ll also discuss maintenance and long-term care based on your age, skin type, and goals.

Simple Ways to Keep the Glow Going

Want to extend the benefits of your treatment? These tips can help maintain healthy, glowing under-eye skin:

  • Stay hydrated – Dehydration can deepen hollows.
  • Wear SPF daily – Protect the delicate eye area from pigment-inducing UV rays.
  • Sleep consistently – Your skin does its best work overnight.
  • Avoid rubbing your eyes – It can irritate and darken over time.
  • Consider touch-ups – Most patients return for subtle maintenance every 12–18 months.

 
The proper habits, combined with expert treatment, go a long way.

A Brighter Look Is Closer Than You Think

Dark circles may be common, but they’re also incredibly treatable—especially with the proper guidance. Dr. Tantisira’s gentle technique and sharp eye for detail help patients look refreshed, confident, and truly like themselves again.

Ready to explore dark circle treatment in Honolulu? Book your consultation today to take the first step.