I have dark circles after losing weight through exercise and strict diet. Creams are not helping, is surgery my only option?

Please be aware that several types of surgical specialists provide care for this area including general plastic surgeons, facial plastic surgeons, oculoplastic surgeons, and even dermatologists.  There is value in see not a generalist like a board certified general plastic surgeon but a specialist like a fellowship trained oculoplastic surgeon.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can help you find a well qualified surgeon close to home to help you with this issue (ASOPRS dot org).You should also know that often non-surgical options can be better than surgery for these issues.  The hyaluronic acid fillers like Restylane have radically changed how care is provided for these issues.  While all of the core aesthetic specialities mentioned above may provide this type of service, you need to look for someone in your area who is particularly good at providing this type of service.

Under eye
hollows are a very common concern for many people. This is one of the most
popular procedures in my office.

The under eye
skin is very thin so only “thinner” Hyaluronic Acid based fillers should be
injected under the eyes, “thicker” Hyaluronic Acid based fillers may cause a
tindle effect (bluish coloring) or lumps and bumps in this area as the product
itself is too thick to be appropriate for injection in this area.

I like to
inject Restylane into the under eye hollows of my patients; I find that it
causes less swelling than Juverderm and has more natural look than Belotero.
The black circles that you see will improve with an under eye treatment because
once the hollows are filled the light will be able to reflect off your skin
improving the look of the dark circles.

It is best
to consult with a Board Certified Dermatologist with plenty of experience treating
under eye hollows to see if this is the right treatment for you.

Dark circles may have a variety of causes including bulging of the lower lid fat pads, which are unrelated to weight, and a deficiency of fat below the fat fads, called a tear trough. Most expert experienced artistic plastic surgeons have a variety of procedures at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, micro-fat grafts, and blepharoplasties. There is no one best procedure. Each has benefits and potential drawbacks.Following the advice of anyone who would presume to tell you what to do without seeing photos  and 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 FACSLa Jolla, California

Congratulations on your weight loss! It is very difficult to be able to say what you need without pictures.  I would suggest scheduling a consultation with a board certified plastic surgeon in your area with experience in treating the eye area for an evaluation and recommendations. Depending on your skin tone some laser treatments may be an options; fillers can occasionally be helpful depending on where and what the problem is specifically. Good luck!

The most important thing is to determine what is causing your dark circles.  Dark circles under the eyes can be caused by excess pigmented, thin eyelid skin which allows the purple eyelid muscle color to show through, lack of eyelid fat and a deep nasal jugal fold, the depression beneath the eyelid.  Each of these causes requires a different specific type of treatment.  For a review of the medical causes of dark circles under the eyes please read the following link: