Laser, filler or both? Is this hemosiderin staining? (Photos)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

The hard science to support the use of PRP and lasers for skin issues lags well behind the heavy marketing to promote them. So, exercise a great deal of "buyer beware" if considering lasers. Of course, photos showing more of the face would have been helpful, but from what can be seen, the use of a volumizing filler for the cheeks would likely improve not only the color, but the tear trough depressions that are seen. Make sure to consult with a board certified cosmetic dermatologist and ask to see his/her personal befores and afters of under eye filler treatments. Best of luck.

You don’t have any haemosiderin in the lower eyelid area. What appears to be a dark circle is actually a shadow which is being cast by the Eye on to the flat cheek. You can easily have this corrected once and for all by means of autologous fat grafting. Fat grafting should produce natural and permanent results as long as it’s been done by a Plastic surgeon with lots of experience in such procedures. I hope this helps and good luck from New York City plastic surgery