Why do the areas around the eyes and mouth age first and what can you do to support them? Dr. Heather Iverson, ND, explains why these delicate, high‑movement areas require a thoughtful dermal filler such as Redensity II to maintain hydration and mobility.
The first areas of the face to show your age? Around the eyes and mouth. These regions are built around sphincter muscles, the orbicularis oculi around the eyes and the orbicularis oris around the mouth, that contract thousands of times a day to blink, smile, drink or speak. Repetitive movement folds the skin along predictable lines; in early adulthood these creases disappear when the face relaxes, but over time the skin loses collagen and elastin and the creases become permanent wrinkles. The periorbital skin is also thin (0.88–2.8 mm) with few sebaceous glands, making it prone to dryness and early wrinkling.
Around the mouth, the muscle becomes more active while the skin thins and bone resorbs; vertical “smoker’s lines” form perpendicular to the direction of the orbicularis oris, especially with repeated pursing or smoking. Lip lines are also called perioral rhytides and develop as part of the natural aging process; the underlying cause is activity of the muscle around the mouth and repetitive movements like sipping through a straw or pursing the lips.
Around the eyes, the orbicularis oculi muscle is almost always working—you blink, squint, smile and laugh all day long. These movements repeatedly fold the thin periorbital skin (only about 0.88–2.8 mm thick). As we age, collagen and elastin fibres decline, so these temporary creases in the skin become static wrinkles. The eye area is also one of the driest parts of the face because it has fewer sweat and sebaceous glands, making it less able to retain moisture. This combination of constant mechanical stress and reduced natural oil production explains why crow’s feet and under‑eye lines often appear before wrinkles elsewhere.
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Why are my dark circles getting worse with age?
Beyond fine lines around the eyes, you may also notice darkening under the eye as you age. Under‑eye dark circles are not purely genetic. Genetics often determine the baseline pigmentation and anatomy, but aging thins the skin, reduces fat and collagen, and changes the bone and ligament structure, making veins and hollows more visible and shadows deeper. Many people notice their dark circles become more pronounced as they get older. Lifestyle factors (sleep, hydration, sun exposure, smoking), allergies and medical issues can further darken the area. Managing these factors—protecting skin from the sun, getting adequate sleep, treating allergies and anemia, staying hydrated, avoiding smoking and excessive alcohol—can lessen the appearance, but when genetic and age‑related structural causes are at the root, there is Redensity II.
Related Relating: Dark Circles? Everything You Need To Know About Under-Eye Filler
What is the best filler for the eye and mouth area?
Redensity II is my trusted filler for your face’s most delicate regions: the eyes and the mouth. When treating these delicate areas, product and technique matter more than in almost any other area. These are not forgiving treatment areas, and even some seasoned cosmetic injectors refuse to treat them due to risk. The skin in the tear‑trough is less than 1 mm thick with almost no subcutaneous fat, and the skin around the mouth is constantly folded and stretched by speech and expression. Thin, mobile tissue means that products which draw in a lot of water can cause puffiness or stiffness, while overly firm gels may restrict natural movement.
The key is selecting the perfect formula—one that behaves well in delicate, dynamic skin, and that can address both volume loss (hollows) and fine lines. Luckily, Redensity II is literally engineered for this purpose. Its formula blends cross‑linked and non‑cross‑linked HA at 15 mg/g, producing a gel with low hygroscopic (water‑attracting) behaviour and a soft viscoelastic profile. This means it draws in less water than many fillers, reducing the risk of post‑injection swelling or the bluish Tyndall effect, which is “permanent” bruising caused from the filler being injected too close to the skin’s surface.
Redensity II contains a dermo‑restructuring complex of amino acids, antioxidants, vitamins and minerals, plus 0.3 % lidocaine for comfort. Its light, cohesive texture spreads smoothly in thin skin and integrates with surrounding tissues, minimising pressure in these delicate areas.
These properties make Redensity II not only my go‑to filler for tear‑trough hollows, but also a versatile tool for smoothing fine lines under the eyes—such as crow’s feet and outer‑canthus wrinkles—and vertical lip lines. The lip area is similarly thin and moves constantly; a soft, stretchable HA gel yields a more natural result. Specifically formulated for mobile areas like the perioral and periorbital regions, Redensity II’s low water‑uptake and cohesive‑but‑supple consistency allow me to soften fine lines without creating stiffness or bulk. Its antioxidant‑rich complex may also support collagen production in the superficial dermis, improving skin quality around the lips and eyes.
Related Reading: Filler Facts, Fears and Finding Balance
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Why do some cosmetic injectors say “no” to under-eye fillers?
There’s a reason not every cosmetic injector offers under-eye filler. This is an area where the approach has to be extremely precise, and where things can go wrong more easily if they’re not. I don’t say this to scare you out of seeking the treatment you desire, but I pride myself on providing my patients all the information they need—including the risks—to make the best choice for them.
Since the tear trough is a delicate area with thinner skin, complex anatomy, and important blood vessels nearby, there’s very little room for error. When it’s done well, it’s subtle—you don’t really notice the filler. When it’s not done well, it tends to show in ways that are harder to ignore or correct. Puffiness, heaviness, lumps, a bluish tone under the skin, or prolonged swelling are all signs that something hasn’t been placed or selected appropriately. In rare cases, more serious complications can happen, including vascular occlusion, skin damage, or vision-related complications, which is why this area should only be treated by a qualified, experienced injector who understands the anatomy and knows when not to treat.
Beyond the risks, undereye filler is simply not a suitable treatment for everyone. Fewer people than you might expect are ideal candidates for under-eye filler, and outcomes are highly dependent on factors like skin quality, underlying structure, and how the area holds fluid.
All this to say, just because you book an undereye filler treatment with me, doesn’t mean we’ll be moving ahead with it. It’s a treatment area where I’m often more selective, and more conservative—because when it comes to the under-eyes, doing less (or sometimes not doing it at all) is often what leads to the best outcome.
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Related Reading: Why I Say No to Cosmetic Injection Trends (and You Should Too)
The First Areas To Age–And How To Support Them
One of the most important principles I work from, as both a Naturopathic Doctor and a cosmetic injector, is that your safety and long-term outcomes always come first. The areas around the eyes and mouth are two of the most delicate, expressive regions of the face. They’re not areas I approach casually, and they’re definitely not areas where a one-size-fits-all treatment makes sense.
My role as your cosmetic injector isn’t to place filler just because it’s been requested. It’s to understand your anatomy, assess what’s actually contributing to the concern, and decide whether something like Redensity II makes sense—or whether it doesn’t. There are plenty of situations where filler can be helpful. And there are just as many where it won’t give you the kind of result you’re looking for. In those cases, I’ll always tell you.
Looking to address perioral lines, dark under-eye circles or under-eye wrinkles in Parksville, Nanaimo, Courtenay, or Langley? Book your consultation with Dr. Heather Iverson, ND today.
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