Darkness, hollowing, bagging, and skin laxity in the under-eye appearance do not represent the same anatomical issue. For this reason, the treatment plan is not made solely based on a photograph; it is created by evaluating lower lid support, fat compartments, the tear trough, skin thickness, history of dry eye, and prior procedures together.
In whom can under-eye endolifting be evaluated?
In mild-to-moderate skin laxity and selected lower lid contour issues, a minimally invasive subdermal laser approach can be considered. However, in cases of marked fat herniation, advanced excess skin, lid laxity, or prominent tear-trough hollowing, different methods may be more appropriate.
Why should bagging, hollowing, and dark circles be distinguished?
- Fat bagging: It is associated with the forward prominence of the fat compartments in the lower lid.
- Tear trough hollowing: It is related to differences in volume and anatomical support; reducing fat can worsen the appearance.
- Dark circles: They can develop due to pigment, superficial vascular appearance, thin skin, or shadowing.
- Edema: It can vary due to allergies, sleep, fluid balance, or systemic causes.
This distinction is important in terms of preventing unnecessary volume loss and selecting the correct method.
What do scientific data show?
In a small case series published in 2022, nine individuals were followed for six months, and positive changes in lower eye bagging and skin characteristics were reported. This study supports the potential benefit of the method in selected patients; however, due to the small sample size, it is not sufficient to provide definitive rates regarding the magnitude of the results and the frequency of rare complications.
A 2024 systematic review reported that Endolift/1470 nm intralesional laser studies generally provided a positive efficacy and safety signal. A 2025 scoping review showed that most of the available publications are case series and that the parameters are quite heterogeneous. For this reason, patient selection and application technique are particularly important around the eyes.
Why is safety more critical around the eyes?
The lower lid is one of the most sensitive areas of the face due to very thin tissues, important neurovascular structures, and proximity to the eyeball. If a procedure is planned, laser-compatible eye protection, the correct anatomical plane, and specific experience in this area are essential requirements. If there is an active eye infection, prominent dry eye, recent eye surgery, or an unexplained eyelid problem, the procedure may be postponed or an ophthalmological/oculoplastic evaluation may be requested.
Recovery process
In the first days, limited swelling, tenderness, or bruising may be seen. Edema around the eyes may be more visible compared to other areas of the face. Recommendations for cold application, medication use, makeup, exercise, and sun protection are personalized according to the scope of the procedure.
If decreased vision, double vision, severe eye pain, or rapidly increasing unilateral swelling develops, an emergency eye evaluation is required without waiting.
Our approach at our Bodrum clinic
First, we distinguish whether the problem is predominantly bagging, hollowing, pigment, vascular appearance, or skin laxity. In suitable cases, Endolifting can be evaluated alone; in cases where it is not suitable, different energy-based treatments, PN/PDRN, fillers, oculoplastic, or surgical options are compared. The goal is to achieve a natural and balanced change around the eyes without causing unnecessary volume loss.
Frequently asked questions
Does it help with under-eye dark circles?
Dark circles are not due to a single cause. If pigment or vascular appearance is predominant, different treatments may be more suitable; therefore, the cause should be determined first.
Is a single session sufficient?
There is no single standard. The follow-up plan is personalized according to tissue response, the scope of the procedure, and the goal.
Does it replace blepharoplasty?
In cases of marked excess skin, eyelid laxity, or advanced fat herniation, surgery can be a more comprehensive and predictable option. Endolifting is oriented toward more limited, minimally invasive goals.
Related content
General guide to Endolifting · Endolifting safety and complications · Skin rejuvenation and wrinkle treatments
References
- Nilforoushzadeh MA et al. Endolift Laser an Effective Method for the Lower Eye Bag Treatment: A Case Series Study. Lasers Med Sci. 2022. PMID: 35534668.
- Nilforoushzadeh MA et al. The Endo-lift Laser (Intralesional 1470 nm Diode Laser) for Dermatological Aesthetic Conditions: A Systematic Review. Aesthetic Plast Surg. 2024. PMID: 38886198.
- Vidal GP et al. Scientific evidence on the impact of endolaser in aesthetics: scoping review. Lasers Med Sci. 2025. PMID: 40116960.
