Sunken Eyes and Flat Cheeks after fat transfer - 29 year old male (Photo)

I think that the most important thing to do in cases of very dark circles under the eyes is to set realistic expectations with your patients.  Determining the cause of the appearance of dark circles and sunken eyes is paramount to choosing the proper treatment and being able to convey the degree of improvement you can expect.  In your case it appears that a filler beneath the eyes, placed skillfully, will help remedy the sunken appearance of your eyes.  The dark circles may also show improvement with filling in the sunken appearance of your eye, however, changes to the pigment of the skin is a far more difficult issue to address.  Lasers, fractionated lasers, and hydroquinone containing creams have all been employed to address this problem with improvement but not complete irradication.  I feel that placing fat into your cheeks, though likely necessary, is not going to improve the appearance of your lower eyelids.  You can elect to undergo a second micro fat graft session to the lower eyelids, but a well placed dermal filler will give you a very good result for a long period of time with no downtime and predictable results.

Appropriately placed fillers with cannulas will limit complications and give great improvement.  Fat can be injected into this area if done properly.  Lasers and microneedling help substantially for the color and radiofrequency (sublative, viva) helps with tightening, texture and tone.  I suggest you find a well trained physician for your treatment.  Best, Dr. Emer.

Fat grafting is by far the best way to reliably treat (sunken) dark lower lid circles.The vascular growth factors improve circulation while the fat volume improves support.Nothing dangerous about it, just highly technique sensitive.Hope this helps