Eyes - Dark Circles and Hollows

Kimberly A. Henry, MD
Article by
Greenbrae Plastic Surgeon

Many women have a condition known as Tear Through - an indentation that starts at the inner corner of the eye and continues to just above the cheek, creating a hollow and dark shadow that makes the eye appear tired even if you are not.  In these cases, surgery or less invasive Fat Injections can restore a smooth contour.

Surgery - Through an incision inside the lower eyelid, your surgeon can reposition excess fat to fill the indentation.  If necessary, the muscles and tendons can be addresses through this incision to help reshape the eye.  If excess skin is an issue, an incision can be made directly underneath the eyelashes.  Dissolving stitched are used to close the internal incision and external stitches are generally removed within five days.  Once healed, the incision should barely be noticeable.

Non Surgical options - Injectable fillers may be used to address the imperfections that stand in the way.  The key is careful patient selection, not all patients are suited for this procedure.   Those with a small depression and good skin elasticity can see great results with this treatment and can avoid or delay surgery. 

For women who have eyelid issues that don’t necessitate surgery, hyaluronic acid Injectables like Juvederm and Restylane can be used to fill the depression and eliminate the shadows that cause dark circles in just on appointment.  Results can last from six month to a year due to the minimal movement in this area.