The Art of Invisibility
“The eyes should whisper, not shout.”
The undereye is the most unforgiving area of facial anatomy. It does not tolerate “over-working.” A fraction of a millimetre too much volume can turn a refreshed look into a puffy, distorted one.
At Eleventh Heaven™, we practice Architectural Medicine. We do not simply “fill” the hollows. We rebuild the deep structural support of the midface that has been lost to time, allowing the undereye skin to drape smoothly once again.
Led by Dr Ricky Sia, our approach is defined by restraint. We often turn patients away if they are not suitable candidates, because we believe that no treatment is better than a poor result.
We operate with strict discretion protocols from our boutique clinic in Teneriffe. Serving patients who value privacy and precision.
The Anatomy of Tiredness - Why We Look "Tired"
Dark circles and bags are rarely just skin deep. They are structural failures of the “Orbital Frame.”
1. The Sliding Cheek (Midface Deficiency)
Imagine a tablecloth sliding off a table. As we age, the cheek fat pads descend, exposing the orbital rim (the bone socket). This creates the “Tear Trough” hollow. Often, we must support the cheek first (and sometimes the temples too) to naturally lift the undereye without placing product directly near the eye.
2. Bone Resorption
The eye socket actually widens with age as bone recedes. This loss of foundation causes the skin to sink inwards, creating shadows that look like dark circles. We restore structural support deep on the bone to mimic the foundation you had in your youth.
3. The Ligament Tether (The Groove)
The Tear Trough Ligament tethers the skin tightly to the bone. In some patients, this ligament is so tight that it creates a permanent indentation. Treatment involves precise placement to soften this transition.
The "Rested" Protocol - The Eleventh Heaven Standard
Our philosophy is “Indirect Treatment.” By supporting the surrounding architecture, we often correct the issue with minimal intervention to the eye area itself.
Tier 1: Midface Support: We frequently begin by restoring the “Lid-Cheek Junction”—the smooth transition between the lower eyelash and the cheek. By treating the cheek, we indirectly shorten the appearance of the lower eyelid.
Tier 2: Direct Tear Trough Correction: For suitable candidates, we use ultra-light, specific treatment options designed for the eye area. These are placed deep, away from the surface, to avoid the “Tyndall Effect” (a blueish tint) or puffiness.
Tier 3: Skin Quality (The Canvas): If the skin is crepey or pigmented, volume alone won’t fix it. We may integrate collagen-stimulating treatments or energy devices to thicken the dermis and improve light reflection.
Are You a Candidate?
Not everyone is suitable for undereye treatment. Dr Ricky is known for his honest refusal of treatment if it will not serve you.
Who We Can Treat:
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Patients with true “hollowing” (a sunken groove).
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Patients with good skin elasticity (the “snap test”).
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Patients looking for improvement, not perfection.
Who We Cannot Treat (Non-Surgical Candidates):
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Large Eye Bags: If you have large, protruding fat pads (herniation), adding volume will only make them look worse. This requires surgical blepharoplasty.
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Malar Oedema (Festoons): Chronic fluid retention on the cheekbones cannot be treated with volume and may be exacerbated by it.
Safety & Risks
The tear trough is considered a high-risk zone in medical aesthetics. It requires a deep understanding of orbital anatomy.
Common Side Effects
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Bruising: The eye area is vascular. Small bruises are common and can take 7–10 days to fade.
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Swelling: Mild swelling is expected for 24–48 hours.
Rare but Serious Risks
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Tyndall Effect: A blueish hue caused by product placed too superficially.
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Vascular Occlusion: A rare medical emergency where blood supply is blocked. Dr Ricky uses ultrasound guidance (where appropriate) and carries emergency reversal agents at all times.
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Blindness: Extremely rare but possible if product enters a vessel connected to the retina. Our cannula technique and deep placement protocols are designed to minimise this specific risk.
FAQs - Tear Trough & Undereye Restoration Brisbane
Will I look puffy?
Puffiness is the result of three errors: using an option that attracts too much water, placing it too superficially, or over-treating. Dr Ricky uses a low-hydrophilic (low water-attracting) method and treats deep on the bone to ensure a crisp, defined result, not a puffy one.
How long does it last?
The undereye area has very low metabolic activity, meaning results often persist significantly longer here than in other areas of the face. Outcomes can be observed for 12–18 months, and sometimes longer. We advise against frequent maintenance to prevent “over-correction.”
Does it hurt?
We use a Cannula technique (a blunt-tipped instrument) rather than sharp needles. This feels like a sensation of pressure but is generally not painful. It also drastically reduces the risk of bruising and vascular complications.