Look young with eyebags

Singaporeans use filler injections to make the area under lower eyelids "pop out" for a youthful look

Many people would do all they can to get rid of their eyebags. But some young Singaporeans are resorting to aesthetic procedures to make their undereye area more prominent because they think it makes them appear more youthful and friendly.

The trend, called "aegyo sal" (say a-gio-sal) in Korean, translates loosely as "cute skin". It started in South Korea a few years ago and recently caught on here.

To make the areas under their lower eyelids "pop out", people usually undergo a filler injection - a 30-minute procedure which costs about $1,000. The effect can also be created through make-up and tightening the lower eyelid muscle via surgery.

At least three aesthetic clinics here say they have been receiving requests for filler injections to the undereye area since early this year.

The team at The Sloane Clinic, which comprises eight aesthetic doctors (general practitioners with a specialised interest in aesthetics) and a plastic surgeon, now performs about 20 to 30 such procedures every month.

Eight out of 10 of these clients are women, mostly in their 20s and 30s. The oldest patient so far is a 48-year-old, who went with her 20-year-old daughter to get the procedure done.

Dr Georgia Lee, founder of TLC Lifestyle Practice, says she has performed the procedure on fewer than five patients since January this year, while Dr Karen Soh, medical director of Prive Clinic, has done it on more than five patients in the same period.

The procedure is similar to how cheek, chin and nose fillers are done, she says.

An anaesthetic cream is first applied to numb the area below the lower eyelid.

A filler, made of hyaluronic acid - which is naturally present in the skin - is then injected into the dermis, or the middle layer of the skin, immediately below the lower eyelash line. This accentuates the pocket of fat found there.

The result, says Dr Low Chai Ling, medical director of The Sloane Clinic, is well-defined fullness of just the lower eyelid, which gives the illusion of bigger eyes.

To create the aegyo sal look, fillers are done on the upper part of the lower eyelid, just below the lower eyelashes.

Eyebags, however, are bulging fat pads in the lower part of the lower eyelid, says Dr Martin Huang, director and plastic surgeon at Cosmetic Surgery Clinic.

He offers filler injections for aegyo sal but has yet to receive any request for it.

While eyebags are often associated with ageing and make the eyes look tired, fullness in the upper part of the lower eyelid area is often associated with young faces, he notes.

"Young people tend to have a natural bulge in the upper part of their lower eyelids due to a prominent lower eyelid muscle or the orbicularis oculi muscle," he says.

As this muscle contracts and becomes more pronounced when people smile, DrLow says a slight bulge in the undereye area is also associated with smiling and gives the appearance of friendlier eyes, even when the face is at rest.

Filler injections for aegyo sal are best done on those with no eyebags and whose undereye skin is firm and supple, she says.

"If you meet these conditions, you can be a candidate for this procedure even if you are a 50-year-old," she adds.

But those with eyebags or loose undereye skin who opt for these fillers may end up making their eyebags more obvious or having their undereye skin sag even more, she warns.

As with all procedures involving injections, prick marks and mild swelling may be visible and these will take one to two days to subside.

Doctors add that the skin around the eyes is thinner, so it is more sensitive and prone to swelling. This can be relieved with cold compresses and arnica tablets after treatment.

In rare cases, there may be bruising, which may take three to seven days to subside.

The effect of the filler injection lasts between six and nine months.

Dr Low says it is generally safe to repeat the procedure as long as it is handled by doctors who are trained in administering the injections.

If one is not satisfied with the results, the procedure can be reversed by injecting an enzyme that dissolves the fillers away in one to two days, she adds.

Those who wish for a more permanent effect can get their lower eyelid muscle surgically tightened under local anaesthesia by a plastic surgeon.

But Dr Huang, as well as plastic surgeons Ivor Lim from Ivor J. Lim Plastic Surgery and Tan Ying Chien from The Sloane Clinic Plastic Surgery Centre, say they have yet to receive such requests.

Dr Lim says this procedure can leave obvious surgical scars in the eyebag area. It is also more expensive than filler injections, starting from about $3,000.

Dr Tan says there are two other ways to create the look via surgery: by harvesting the required fat from other parts of the body and then injecting it just under the lower eyelashes, or inserting artificial tissue, called allogenic dermis, just below the lower eyelashes.

But going the temporary way seems to be what those interviewed prefer.

A full-time blogger who goes by the screen name Yutaki James paid $1,000 for a filler injection to his lower eyelids last month. The 25-year-old, who blogs on current lifestyle trends, declines to give his real name.

He saw advertisements on the procedure when he visited South Korea last year.

"When I knew it was available here, I decided to get it done because I wanted to keep up with trends. I also wanted to make my eyes look bigger."

During the procedure, he also had fillers to make his laugh lines and dark circles under his eyes less obvious.

He says he felt no pain but there was some swelling under his eyes on the first two days. This gradually disappeared after the first week.

"I am happy with the effect. My friends say I look younger and more awake."

But full-time blogger Miyake Ng, 23, prefers to create the effect through make-up. She learnt about "aegyo sal make-up" from watching a Korean variety show on YouTube about a year ago.

Since then, she has experimented with different eyeshadows and eyebrow pencils to come up with the desired effect.

She puts on the make-up, which involves shading the undereye area with an eyebrow pencil, each time she goes out.

"Most people I meet say they like the look. They say it makes my eyes look bigger and make me appear younger and friendlier."

At her friends' request, she uploaded a YouTube tutorial last month on her make-up routine, including how to create the aegyo sal look. It has received more than 17,000 views since.

"I won't go for any procedure to create the effect as I can create it equally well with make-up," she says.

"Also, most of my followers are teenagers who may not have the money to undergo the procedure."

What do you think of the "aegyo sal"' look? E-mail

This story was first published in The Straits Times on Sept 8, 2013To subscribe to The Straits Times, please go to