{"id":10156,"date":"2026-08-08T18:51:47","date_gmt":"2026-08-08T09:51:47","guid":{"rendered":"https:\/\/kojihifu.com\/english\/?p=10156"},"modified":"2026-08-10T18:40:46","modified_gmt":"2026-08-10T09:40:46","slug":"under-eye-dark-circles-treatment-tokyo-2","status":"publish","type":"post","link":"https:\/\/kojihifu.com\/english\/under-eye-dark-circles-treatment-tokyo-2\/","title":{"rendered":"Under Eye Dark Circles Treatment Tokyo: Injections vs Surgery"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"Can I have filler and surgery at the same time?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"In most cases, a surgeon will assess which approach is appropriate before combining treatments. Occasionally, fat repositioning during surgery reduces the need for filler altogether. If filler is required alongside surgery, this is typically discussed at the surgical consultation and planned on an individual basis.\"}}, {\"@type\": \"Question\", \"name\": \"How long is the recovery after tear trough filler?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Most patients experience mild swelling and possible bruising for three to seven days. Makeup can generally be applied after 24 hours if there are no open injection points. The final result is usually visible within one to two weeks once any initial swelling has settled.\"}}, {\"@type\": \"Question\", \"name\": \"I had filler elsewhere and I am not happy with the result. Can it be corrected?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Yes, in many cases. Hyaluronidase (an enzyme that dissolves hyaluronic acid filler) can be used to partially or fully reverse previous filler treatments. Dr. Karibe can assess the existing result and advise on whether dissolution, additional volume, or a different approach is most appropriate. Hyaluronidase is available at BIOTOPE CLINIC at \u00a511,000\u2013\u00a522,000.\"}}, {\"@type\": \"Question\", \"name\": \"Is transconjunctival blepharoplasty covered by health insurance in Japan?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"In most cases, this procedure is classified as cosmetic and is not covered by Japan's national health insurance (shakai hoken or kokumin kenko hoken). Insurance coverage may apply in specific medically indicated situations, but this requires assessment by a physician. Insurance-covered procedures of this nature are handled at Kojimachi Dermatology &amp; Plastic Surgery Clinic (Japanese-language), not at BIOTOPE CLINIC.\"}}, {\"@type\": \"Question\", \"name\": \"Are results from tear trough filler natural-looking?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"When performed by an experienced injector with appropriate product selection, tear trough filler can produce very natural results. The risk of an unnatural or \\\"overfilled\\\" appearance increases when too much product is used or when filler is placed in a patient whose anatomy is better suited to surgical correction. Clinical reports indicate that under-correction is generally safer than overcorrection in this area, as excess filler under the thin periorbital skin is more visible than in other facial regions.\"}}]}<\/script><\/p>\n<h2>Under-Eye Dark Circles in Tokyo: Injections vs Surgery \u2014 Which Treatment Is Right for You?<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Under-Eye Dark Circles in Tokyo: Injections vs Surgery \u2014 Whi\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_6762729_1786148202.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Under-Eye Dark Circles in Tokyo: Injections vs Surgery \u2014 Whi\" \/><\/figure>\n<p><em><strong>Dark circles<\/strong> <\/em>under the eyes are one of the most common cosmetic concerns among both men and women, and one of the most frustrating \u2014 they can persist regardless of how well you sleep or how carefully you care for your skin.<\/p>\n<p>If you have been searching for a reliable, medically supervised solution in Tokyo, this guide explains your two main options: injectable treatments and surgical correction.<\/p>\n<p>Below, you will find a clear comparison of both approaches, realistic expectations, approximate costs in Tokyo, and guidance on which option may suit your situation.<\/p>\n<p><strong>What you&#8217;ll learn in this article:<\/strong><\/p>\n<ul>\n<li>The main causes of under-eye dark circles and why the cause determines the treatment<\/li>\n<li>How hyaluronic acid filler injections and surgical transconjunctival blepharoplasty each work<\/li>\n<li>A side-by-side comparison of both approaches: downtime, longevity, and suitability<\/li>\n<li>Realistic cost ranges for under-eye treatments at a Tokyo cosmetic clinic<\/li>\n<li>Who is a good candidate for each option, and common misconceptions to avoid<\/li>\n<\/ul>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Why Dark Circles Are Not All the Same<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Why Dark Circles Are Not All the Same\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_6763790_1786148203.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Why Dark Circles Are Not All the Same\" \/><\/figure>\n<p>Before comparing treatments, it is important to understand that<strong> &#8220;dark circles&#8221;<\/strong> is an umbrella term covering several distinct conditions. Choosing a treatment without identifying the underlying cause is one of the most common reasons patients are disappointed with their results.<\/p>\n<h3>The four main types<\/h3>\n<ul>\n<li><strong>Vascular (bluish\/purple):<\/strong> Thin skin allows the underlying muscle and blood vessels to show through, creating a bluish or purple shadow. Common in younger patients and in people with lighter skin tones.<\/li>\n<li><strong>Pigmentation (brown):<\/strong> Excess melanin in the skin itself, often related to sun exposure, post-inflammatory changes, or genetics. More common in East Asian, South Asian, and Middle Eastern skin types.<\/li>\n<li><strong>Structural (shadow):<\/strong> A hollow or groove between the lower eyelid and the cheek \u2014 known as the tear trough \u2014 casts a shadow that reads as a dark circle. This is a volume and anatomy issue, not a pigment issue.<\/li>\n<li><strong>Mixed:<\/strong> A combination of the above, which is very frequently encountered in clinical practice.<\/li>\n<\/ul>\n<p>Injectable treatments address structural and vascular causes most effectively. Surgical intervention is most appropriate when excess fat is creating a bulge, deepening the shadow beneath it, or when structural correction is required that filler alone cannot achieve.<\/p>\n<h2>Option 1 \u2014 Hyaluronic Acid Filler Injections (Tear Trough Filler)<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Option 1 \u2014 Hyaluronic Acid Filler Injections (Tear Trough Fi\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_4586708_1786148204.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Option 1 \u2014 Hyaluronic Acid Filler Injections (Tear Trough Fi\" \/><\/figure>\n<h3>How it works<\/h3>\n<p><strong>Hyaluronic acid (HA) filler<\/strong> is a gel-like substance that is injected beneath the skin to restore volume in the tear trough area \u2014 the groove that runs from the inner corner of the eye toward the cheek.<\/p>\n<p>By lifting this hollow, the shadow that creates the appearance of a dark circle is reduced. The procedure takes approximately 15 to 30 minutes and requires no general anaesthesia.<\/p>\n<p>HA filler attracts and retains water, providing a plumping effect. Because hyaluronic acid is a naturally occurring substance in the body, the risk of allergic reaction is low. Results are visible almost immediately, with some improvement in the days following as swelling subsides.<\/p>\n<h3>What to expect: before, during, and after<\/h3>\n<p>Before treatment, a detailed consultation is conducted to assess the tear trough anatomy, skin thickness, and the likely cause of the dark circles. A topical numbing cream is applied prior to injection.<\/p>\n<p>The injections themselves are brief, though the area under the eye is sensitive and some mild discomfort is normal.<\/p>\n<p>After treatment, minor swelling and occasional bruising may appear for three to seven days. Patients are advised to avoid strenuous exercise, alcohol, and direct sun exposure for 48 hours. Most people are able to return to work the following day, making this a relatively low-downtime option.<\/p>\n<h3>Longevity<\/h3>\n<p>HA filler in the tear trough area typically lasts between 9 and 18 months, though individual results vary. The filler can be partially or fully dissolved using an enzyme called hyaluronidase if the result is unsatisfactory or if revision is needed \u2014 an important safety consideration in a delicate area such as the under-eye.<\/p>\n<blockquote style=\"border-left: 4px solid #5a8a5a; padding: .75em 1.1em; margin: 1.8em 0; background: #f7fbf7; border-radius: 0 6px 6px 0; font-size: .93em;\">\n<p style=\"margin: 0 0 .45em; font-weight: bold; color: #3a6e3a;\">Dr. Karibe&#8217;s Note<\/p>\n<p style=\"margin: 0; color: #333; line-height: 1.7;\">Many of our international patients are surprised to find that tear trough filler is not always the right first step. In consultations at <strong>BIOTOPE CLINIC<\/strong>, I frequently assess patients who were told they needed surgery when filler would have been sufficient \u2014 and equally, patients who had repeated filler treatments when the underlying cause was excess fat that could only be corrected surgically.<\/p>\n<p style=\"margin: 0; color: #333; line-height: 1.7;\">A careful assessment of what is actually causing the shadow is far more important than the treatment itself. There is no one-size-fits-all approach to the under-eye area.<\/p>\n<\/blockquote>\n<h2>Option 2 \u2014 Transconjunctival Blepharoplasty (Under-Eye Surgery)<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Option 2 \u2014 Transconjunctival Blepharoplasty (Under-Eye Surge\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_6762725_1786148206.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Option 2 \u2014 Transconjunctival Blepharoplasty (Under-Eye Surge\" \/><\/figure>\n<h3>How it works<\/h3>\n<p>Transconjunctival blepharoplasty is a surgical procedure designed to address excess or herniated fat pockets beneath the lower eyelid. The term &#8220;transconjunctival&#8221; means the incision is made on the inner surface of the eyelid (the conjunctiva), leaving no visible external scar. The surgeon removes or repositions the fat that is causing a bulge and the resulting shadow beneath it.<\/p>\n<p>This procedure is performed under local anaesthesia (with or without sedation) and typically takes 60 to 90 minutes. It addresses the structural root cause of shadow-type dark circles in a way that is not achievable with filler alone.<\/p>\n<h3>What to expect: before, during, and after<\/h3>\n<p>Pre-operative blood work and a surgical consultation with Dr. Karibe are required before the procedure. During surgery, the patient is awake but comfortable. Some pressure and mild sensation may be felt, but the procedure should not be painful.<\/p>\n<p>Downtime is more significant than with filler. Swelling and bruising around the eyes should be anticipated for one to three weeks. Most patients are able to return to desk work within five to seven days, though strenuous activity should be avoided for two to four weeks. Final results are typically assessed at three to six months, once all swelling has fully resolved.<\/p>\n<h3>Longevity<\/h3>\n<p>The results of transconjunctival blepharoplasty are long-lasting.<\/p>\n<p>Because fat does not generally regenerate after removal, many patients consider this a permanent improvement, though the natural ageing process continues over time. Clinical evidence supports a high long-term satisfaction rate: one published review in the journal <em>Aesthetic Surgery Journal<\/em> reported patient satisfaction rates above<strong> 85%<\/strong> at long-term follow-up following lower blepharoplasty procedures.<\/p>\n<p>Transconjunctival blepharoplasty is available at <strong>BIOTOPE CLINIC<\/strong> in Shirokanedai \u2014 feel free to ask about candidacy and what the procedure involves during a consultation with Dr. Karibe.<\/p>\n<h2>Side-by-Side Comparison<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Side-by-Side Comparison\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_7290673_1786148208.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Side-by-Side Comparison\" \/><\/figure>\n<table style=\"border-collapse: collapse; width: 100%; margin: 20px 0; font-size: 0.95em; border: 1px solid #ccc;\">\n<thead>\n<tr>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Factor<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">HA Filler (Tear Trough)<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Transconjunctival Blepharoplasty<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Best for<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Hollow tear trough, volume loss, vascular shadows<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Excess fat \/ bulging, deep structural shadow<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Procedure time<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">15\u201330 minutes<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">60\u201390 minutes<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Anaesthesia<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Topical numbing cream<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Local anaesthesia (sedation optional)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Downtime<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">3\u20137 days (bruising\/swelling)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">1\u20133 weeks (swelling\/bruising)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Visible scar<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">None<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">None (internal incision)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Results visible<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Immediately (final result: 1\u20132 weeks)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">3\u20136 months (final result)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Longevity<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">9\u201318 months<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Long-lasting (years)<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Reversible<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Yes (hyaluronidase)<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">No<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\"><strong>Approximate cost at BIOTOPE CLINIC<\/strong><\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">From \u00a566,000 per syringe<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">\u00a5280,000\u2013\u00a5428,000<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Cost of Under-Eye Treatments in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"Under eye dark circles treatment Tokyo: injections \u2014 Cost of Under-Eye Treatments in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/08\/pexels_7581583_1786148209.webp\" alt=\"Under eye dark circles treatment Tokyo: injections \u2014 Cost of Under-Eye Treatments in Tokyo\" \/><\/figure>\n<h3>Hyaluronic acid filler<\/h3>\n<p>At <strong>BIOTOPE CLINIC<\/strong>, hyaluronic acid filler is priced at <strong>\u00a566,000\u2013\u00a588,000 per syringe<\/strong>. Tear trough correction typically requires one syringe, though this varies by individual anatomy. An initial consultation fee of \u00a55,500 applies. If future revision or dissolution is needed, hyaluronidase is available at \u00a511,000\u2013\u00a522,000.<\/p>\n<h3>Transconjunctival blepharoplasty<\/h3>\n<p>Surgical correction is priced at <strong>\u00a5280,000\u2013\u00a5428,000<\/strong>, reflecting the complexity of the procedure and the level of surgical expertise required. Additional costs include a surgical consultation with Dr. Karibe (\u00a53,300), pre-operative blood work (\u00a511,000), and anaesthesia (\u00a52,200\u2013\u00a577,000 depending on the type used).<\/p>\n<p>These figures represent the clinic&#8217;s published price range. The final cost depends on the extent of correction required and the anaesthesia approach chosen. For an accurate quote, we recommend booking a consultation.<\/p>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Common Misconceptions About Under-Eye Dark Circle Treatments<\/h2>\n<h3>Misconception 1: &#8220;Filler always fixes dark circles&#8221;<\/h3>\n<p>Tear trough filler is highly effective for hollowing and volume loss, but it will not correct dark circles caused primarily by pigmentation (excess melanin in the skin) or by fat herniation causing a bulge. In some cases, adding filler over pre-existing fat pockets can actually worsen the appearance by increasing fullness where it is not needed. An honest assessment of the underlying cause is essential before any treatment is selected.<\/p>\n<h3>Misconception 2: &#8220;Surgery leaves visible scars under the eyes&#8221;<\/h3>\n<p>The transconjunctival approach is specifically designed to avoid external scarring. The incision is made on the inside of the eyelid, which means there is no visible mark on the skin surface. This is one of the principal advantages of this technique over traditional lower blepharoplasty, which uses an external incision. Studies suggest that the transconjunctival approach carries a lower risk of lower eyelid retraction compared with the external (subciliary) incision method \u2014 a relevant consideration when evaluating surgical risk.<\/p>\n<h2>Who Is a Good Candidate?<\/h2>\n<h3>Good candidates for filler<\/h3>\n<ul>\n<li>Patients with a visible hollow or groove in the tear trough area<\/li>\n<li>Those with thin skin making blood vessels visible beneath the surface<\/li>\n<li>Patients who prefer a non-surgical approach with minimal downtime<\/li>\n<li>Those who want a reversible, lower-commitment option before considering surgery<\/li>\n<\/ul>\n<h3>Good candidates for transconjunctival blepharoplasty<\/h3>\n<ul>\n<li>Patients with visible fat pockets (&#8220;bags&#8221;) beneath the lower eyelid<\/li>\n<li>Those for whom repeated filler treatments have provided insufficient improvement<\/li>\n<li>Patients in good general health who are prepared for a surgical recovery period<\/li>\n<li>Those seeking a long-lasting structural correction rather than a temporary result<\/li>\n<\/ul>\n<h3>Who should exercise caution or seek medical advice first<\/h3>\n<ul>\n<li>Patients with a history of keloid scarring (relevant for all surgical procedures)<\/li>\n<li>Those taking blood-thinning medications such as aspirin or warfarin<\/li>\n<li>Patients with dry eye syndrome, as surgery in the lower eyelid area can temporarily affect tear film stability<\/li>\n<li>Pregnant or breastfeeding women (injectable treatments are generally deferred)<\/li>\n<li>Patients whose dark circles are primarily pigmentary in origin \u2014 laser or skin-brightening treatments may be more appropriate in such cases<\/li>\n<\/ul>\n<p>In Dr. Karibe&#8217;s clinical experience at <strong>BIOTOPE CLINIC<\/strong>, a number of patients present having already had filler at another clinic, seeking advice because results were uneven or swelling persisted. A careful pre-treatment assessment \u2014 including evaluating skin thickness, fat compartment anatomy, and skin tone \u2014 significantly reduces the likelihood of this outcome.<\/p>\n<h2>Where to Get Under-Eye Dark Circle Treatment in Tokyo<\/h2>\n<p>Within our clinic group, English-speaking consultations are handled at <strong>BIOTOPE CLINIC in Shirokanedai (Minato-ku, Tokyo)<\/strong> by Dr. Jun Karibe, a board-certified plastic surgeon certified by the Japan Society of Plastic and Reconstructive Surgery. Our sister clinic, <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic<\/strong> in Ichigaya (Chiyoda-ku), handles Japanese-language insurance-covered dermatology and serves as the group&#8217;s main office. Bookings and enquiries in English are handled at BIOTOPE CLINIC via LINE or WhatsApp.<\/p>\n<h2>Frequently Asked Questions<\/h2>\n<dl class=\"kj-faq\">\n<dt>Q. Can I have filler and surgery at the same time?<\/dt>\n<dd>In most cases, a surgeon will assess which approach is appropriate before combining treatments. Occasionally, fat repositioning during surgery reduces the need for filler altogether. If filler is required alongside surgery, this is typically discussed at the surgical consultation and planned on an individual basis.<\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dt>Q. How long is the recovery after tear trough filler?<\/dt>\n<dd>Most patients experience mild swelling and possible bruising for three to seven days. Makeup can generally be applied after 24 hours if there are no open injection points. The final result is usually visible within one to two weeks once any initial swelling has settled.<\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dt>Q. I had filler elsewhere and I am not happy with the result. Can it be corrected?<\/dt>\n<dd>Yes, in many cases. Hyaluronidase (an enzyme that dissolves hyaluronic acid filler) can be used to partially or fully reverse previous filler treatments. Dr. Karibe can assess the existing result and advise on whether dissolution, additional volume, or a different approach is most appropriate. Hyaluronidase is available at <strong>BIOTOPE CLINIC<\/strong> at \u00a511,000\u2013\u00a522,000.<\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dt>Q. Is transconjunctival blepharoplasty covered by health insurance in Japan?<\/dt>\n<dd>In most cases, this procedure is classified as cosmetic and is not covered by Japan&#8217;s national health insurance (shakai hoken or kokumin kenko hoken). Insurance coverage may apply in specific medically indicated situations, but this requires assessment by a physician. Insurance-covered procedures of this nature are handled at Kojimachi Dermatology &amp; Plastic Surgery Clinic (Japanese-language), not at <strong><em>BIOTOPE CLINIC.<\/em><\/strong><\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dd><\/dd>\n<dt>Q. Are results from tear trough filler natural-looking?<\/dt>\n<dd>When performed by an experienced injector with appropriate product selection, tear trough filler can produce very natural results. The risk of an unnatural or &#8220;overfilled&#8221; appearance increases when too much product is used or when filler is placed in a patient whose anatomy is better suited to surgical correction. Clinical reports indicate that under-correction is generally safer than overcorrection in this area, as excess filler under the thin periorbital skin is more visible than in other facial regions.<\/dd>\n<\/dl>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Summary<\/h2>\n<p><strong>Under-eye dark circles<\/strong> have more than one cause, and the most effective treatment depends on accurate identification of that cause. Hyaluronic acid filler is a well-established, reversible option for volume loss and tear trough hollowing, with minimal downtime and results achievable within days.<\/p>\n<p><strong>Transconjunctival blepharoplasty<\/strong> is the appropriate choice when excess fat beneath the lower eyelid is the structural cause of the shadow \u2014 offering a long-lasting correction without visible scarring.<\/p>\n<p>Neither approach is universally superior. The choice between injections and surgery should follow a thorough clinical assessment, not a general preference. A qualified plastic surgeon with specific experience in periorbital anatomy is best placed to advise on which option \u2014 or combination of options \u2014 is appropriate for your individual presentation.<\/p>\n<p>If you have questions about under-eye dark circle treatments, English-speaking consultations are handled at <strong>BIOTOPE CLINIC in Shirokanedai (Minato-ku, Tokyo)<\/strong> by Dr. Karibe. Our sister clinic <strong>Kojimachi Dermatology &amp; Plastic Surgery Clinic in Ichigaya (Chiyoda-ku)<\/strong> handles Japanese-language insurance dermatology. English enquiries: LINE or WhatsApp.<\/p>\n<div class=\"kjmc-en-booking-box\" style=\"background: linear-gradient(135deg,#f1faf3 0%,#e6f3ea 100%); border-radius: 14px; padding: 32px 24px; margin: 36px 0 24px; border: 1px solid #c5dccd; text-align: center;\">\n<h3 style=\"margin: 0 0 8px; color: #3a6e3a; border: none; padding: 0; font-size: 1.3em;\">24\/7 Consultation &amp; Booking<\/h3>\n<div style=\"width: 48px; height: 2px; background: #3a6e3a; margin: 0 auto 22px;\"><\/div>\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 1.1em; font-weight: bold;\">Book a Consultation or Treatment<\/p>\n<p style=\"margin: 0 0 24px; color: #2c4a35; line-height: 1.75;\">Our English-speaking team responds via LINE or WhatsApp \u2014 usually the same day.<\/p>\n<p style=\"margin: 0 0 10px; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #06C755; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(6,199,85,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #25D366; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(37,211,102,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>References<\/h2>\n<ol>\n<li>Goldberg RA, Edelstein C, Balch K. Fat repositioning in lower eyelid blepharoplasty. <em>Seminars in Ophthalmology<\/em>. 1998.<\/li>\n<li>Haddock NT, Saadeh PB, Boutros S, Thorne CH. The tear trough and lid\/cheek junction: anatomy and implications for surgical correction. <em>Plastic and Reconstructive Surgery<\/em>. 2009.<\/li>\n<li>De Pasquale A, Russa G, Pulvirenti M, Di Rosa L. Hyaluronic acid filler injections for tear-trough deformity: injection technique and high-frequency ultrasound follow-up evaluation. <em>Aesthetic Plastic Surgery<\/em>. 2013.<\/li>\n<li>Morley AM, Malhotra R. Use of hyaluronic acid filler for tear-trough rejuvenation as an alternative to surgery. <em>Ophthalmic Plastic and Reconstructive Surgery<\/em>. 2011.<\/li>\n<li>Rohrich RJ, Ghavami A, Mojallal A. The five-step lower blepharoplasty: blending the eyelid-cheek junction. <em>Plastic and Reconstructive Surgery<\/em>. 2011.<\/li>\n<\/ol>\n<h2>Related Articles<\/h2>\n<p>You may also find these articles useful.<\/p>\n<ul>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-filler-tokyo-risks-benefits-3\/\" target=\"_blank\" rel=\"noopener\">Under Eye Filler Tokyo: Risks, Benefits &amp; Costs<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-bags-surgery-tokyo\/\" target=\"_blank\" rel=\"noopener\">Under Eye Bags Surgery Tokyo: Transconjunctival Blepharoplasty<\/a><\/li>\n<\/ul>\n<div style=\"margin: 2.5em 0 1em; padding: 1.5em; border: 1px solid #d5d5d5; border-radius: 10px; background: #fafafa; font-size: .9em;\">\n<p style=\"font-size: .72em; font-weight: bold; color: #888; margin: 0 0 1.2em; letter-spacing: .08em;\">SUPERVISED BY<\/p>\n<div style=\"display: flex; align-items: flex-start; gap: 1.2em; flex-wrap: wrap;\">\n<div style=\"flex-shrink: 0; text-align: center; min-width: 110px;\"><img decoding=\"async\" style=\"width: 100px; height: 100px; border-radius: 50%; object-fit: cover; object-position: top center; display: block; margin: 0 auto; border: 3px solid #e0e0e0;\" src=\"https:\/\/kojihifu.com\/hon\/wp-content\/uploads\/2022\/01\/photo-karibejun-400-3_re-300x300.jpg\" alt=\"Dr. Jun Karibe MD \u2014 Board-certified Plastic Surgeon, Director of Kojimachi Dermatology &amp; Plastic Surgery Clinic\" \/><\/p>\n<p style=\"margin: .6em 0 .1em; font-weight: bold; font-size: .95em; color: #222;\">Dr. Jun Karibe<\/p>\n<p style=\"margin: 0 0 .1em; font-size: .75em; color: #999;\">MD<\/p>\n<p style=\"margin: 0; font-size: .75em; color: #555; font-weight: bold;\">Director<\/p>\n<\/div>\n<div style=\"flex: 1; min-width: 200px;\">\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Education &amp; Career<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Juntendo University School of Medicine<\/div>\n<div>Department of Plastic Surgery, University of Tokyo Hospital<\/div>\n<div>Assistant Professor, Plastic &amp; Cosmetic Surgery, Saitama Medical University<\/div>\n<div>Assistant Professor &amp; Chief Resident, Yamanashi University Hospital<\/div>\n<div>2019: Founded Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Tokyo)<\/div>\n<div>2021: Founded BIOTOPE CLINIC Shirokanedai (Minato-ku, Tokyo)<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Certifications<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Specialist \u2014 Japan Society of Anti-Aging Medicine<\/div>\n<div>Certified Industrial Physician \u2014 Japan Medical Association<\/div>\n<div>Allergan VST-certified Injector (Botox &amp; Hyaluronic Acid)<\/div>\n<\/div>\n<\/div>\n<div style=\"background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Awards<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Best Presentation Award \u2014 Dept. of Plastic Surgery, University of Tokyo (2016)<\/div>\n<div>Excellence Award \u2014 Japan Society of Plastic and Reconstructive Surgery (2018)<\/div>\n<div>Featured Presentation \u2014 ASPS Annual Scientific Meeting, USA (2018)<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px solid #e8e8e8; display: flex; flex-wrap: wrap; align-items: center; gap: .5em;\"><a style=\"display: inline-block; background: #e1306c; color: #fff; padding: .4em .9em; border-radius: 4px; text-decoration: none; font-size: .8em; font-weight: bold;\" href=\"https:\/\/www.instagram.com\/dr.jun_\/\" target=\"_blank\" rel=\"noopener noreferrer\">Instagram<\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"Compare under eye dark circles treatment in Tokyo: injectable fillers vs surgical blepharoplasty. Learn costs, downtime, and which option suits you best.","protected":false},"author":4,"featured_media":10155,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[661,662,558,531,302,83,51],"class_list":["post-10156","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-skin-dermatology","tag-under-eye-dark-circles","tag-surgical-correction","tag-dermal-fillers","tag-injectable-treatments","tag-eye-rejuvenation","tag-blepharoplasty","tag-tokyo-cosmetic-clinic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/10156","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/comments?post=10156"}],"version-history":[{"count":2,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/10156\/revisions"}],"predecessor-version":[{"id":10250,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/10156\/revisions\/10250"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media\/10155"}],"wp:attachment":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media?parent=10156"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/categories?post=10156"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/tags?post=10156"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}