The Various Causes of Under Eye Dark Circles and Non-Surgical Treatments to Address Them

Best Treatment for Under Eye Hollows & Dark
Circles? I have under eye hollows as well as dark purple
circles within the hollows that have become more prominent every year. I’ve always had
the under eye hollows, which progressively look more sunken. I’m tired of constantly
looking tired. I’ve read about Restylane being a good option for this area, but is it the
best treatment for my situation? What are my other options? If I received the Restylane
filler treatment, would it help remove the dark circles too? Thank you for your question. You submitted some very good photos and you’re
asking about treating the dark circles under your eyes and you describe very well its purplish.
And it’s very important to understand the basic cause of the dark circles and I know
you’ve asked Restylane as a possible treatment. So what is it that makes your eyes look so
purplish and so tired? Well, dark circles are typically caused by
hereditary ethnic dark circles. For example, a lot of people of Indian origin, Arab origin
will have dark circles because of pigmentation genetics. Other things can cause dark circles
actually opposite lack of pigment, the absence of pigment or the thinness or quality of skin
where the skin is almost transparent and is only half a millimeter in thickness, very
thin so you can literally see thought the skin and look at the blood vessels and the
muscle that can create a bluish hue. Now many times, people who are very light-skinned
have this issue. The things that can aggravate this issue I have seen includes smoking and
sun exposure, anything that can cause the skin to be thinner can cause this dark circle
appearance to progress further. Now although a filler can help fill in a hollow, it can’t
completely reduce the dark circles appearance completely but something that I have noticed
about your photos that you didn’t mention in your question is it appears to be some
lower eyelid fat prolapse. Now what that means is not only do you have the dark circles but
you have a bulge fat pockets in the inner aspect that’s making the eyes look puffy. Many of my patients over 20 years of doing
this have complained of dark circles when they first came in and then when I pointed
it out to them they also have fat pockets, we decided that a combination approach would
make sense. Now what does that mean? Well, think of it this way: If your eyelid is very
thin, the skin is accentuating everything by the translucency of it. Well, the fat pockets
are pushing forward, it’s like you’re pushing that appearance of dark circles forward and
when people look at you, we look at ourselves with great detail. Whatever we see we tend
to focus on and magnify that when people come to our practices like if they don’t like the
way bags under their eyes, they look, they notice that all the time. So there is a lot
of reason why that’s why a lot of people come to our office. They come because there is
a dominant issue that concerns them that makes them want to seek attention. So when I help people with situations like
yours, very often I’ll do a combination where I would address the fat pockets. And if a
younger person what appears to be may apply to you based on your photos, I would do something
called transconjunctival blepharoplasty. Now what that means is I’ll go inside the eyelids
and address the fat pockets so they are not pushing forward and bulging. Now that can
help take away the accentuation of the dark circles. I also would routinely combine that
with the use of platelet-rich plasma and sometimes with fractional Co2 laser. I’ll help you understand
that a little bit better.


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