Which treatment would remove my dark circles? (Photo)
Doctor Answers 4
Dark circles can be improved with a combination of non-surgical treatments to address pigmentation, skin quality, and hollowing
When I look at a patient with this concern, I break down the treatable elements that contribute to dark circles, and how they contribute to the overall appearance of the eyes. In the lower eyelid, I look at the pigmentation of the skin, the skin quality and the areas with relative hollowing. In particular, we pay attention to an area called the tear trough - where the edge of the eyelid meets the cheek area. I also look at the under eye area for puffiness or under eye bags and I look at the area adjacent to the eyelid and cheek called the eyelid-to-cheek junction to look at the orbital rim or the bone under the eye as well as the cheek volume. So you can see, there are many levels to treat, approach and address the under eye circles.
As someone who has been in practice and performing oculofacial plastic surgery for over 20 years, I can say that there were very few options many years ago. Today we have some options to share with you. The hollowing component of the under eye dark circles means that it needs some type of volume enhancement. We’re fortunate to have a lot of fillers such as those in the hyaluronic acid family like Restylane. Restylane can be placed very strategically in the tear trough area. However, it is not done exactly the same between doctors. There’s an art to filling that space to help soften the depth, darkness and shadow created by the relative hollow.
In addition, we have been using a material that’s derived from your own blood called platelet-rich plasma. Platelet-rich plasma uses the components of your blood that are required for healing called platelets, and the plasma that is rich in growth factors that stimulates the quality of the skin. When there’s a genetic dark circle under the eyes, platelet-rich plasma improves circulation and collagen production. In addition, we combine platelet-rich plasma with hyaluronic acid to have a synergistic benefit. Based in wound healing literature, the combination of platelet-rich plasma with hyaluronic acid enhances volume, blood supply and healing response. Although the response to these procedures vary from patient to patient, it has a long-term benefit which I feel is superior to using a filler alone, and that’s a very important distinction.
This type of work requires both the treatment and observation of the response, and no two patients respond the same way. I think that in your situation, it is worthwhile exploring platelet-rich plasma, hyaluronic acid fillers and the combination as a strategy to help you improve the dark circles under your eyes. Meet with qualified experienced cosmetic surgeons who perform these procedures and hopefully you will get a result that you are happy with. I hope that was helpful, I wish you the best of luck, and thank you for your question.
Dark circles around eyes
Dark eyelid circles?
Following the advice of anyone who would presume to tell you what to do based on limited 2 dimensional photos without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California