Why can I do about my dark circles and hollow eyes? (photos)

Thank you for your question. You are asking about what you can do about your eye bags, dark circles, hollowness, and wrinkles that appear when you smile.I can certainly help you with this, as an oculoplastic surgeon practicing in Manhattan and Long Island for over 20 years. I can give you some guidance based on your images alone, and without the benefit of a physical exam.While I can notice the hollowness and dark circles from your pictures, eye bags caused by fat are not as apparent, but you may be mistaking the slight bulge under your eyes as an eye bag. A slight bulge directly under the eye is the orbicularis oculi muscle, which helps support the lower eyelid. When this muscle contracts with actions such as smiling, it can appear to bulge, and also cause the lower eyelid skin to bunch, which you may mistake for wrinkles. This is actually completely normal, and I don't recommend treatment for this. Limiting the activity of the orbicularis oculi muscle with a neurotoxin like Botox, which can be applied for crow's feet at the sides of the eyes, would temporarily paralyze the muscle, or restrict muscle movement, which would compromise lower eyelid support, and affect common facial movements and expressions like smiling. I would not recommend treatment for this bulge, or for the skin bunching when you smile.As for dark circles and hollowness, this could be treated with non-surgical treatments. Dark circles can be caused by thin eyelid skin, which reveals the darker anatomy beneath it. Eyelid skin is already the thinnest in the body at 0.5 mm thick, so if it's any thinner, it can be translucent and reveal the anatomy beneath. Dark circles can also be caused by ethnic pigmentation, iron deposits, excess sun exposure, pooled blood, and other causes. The genetic lack of volume under the eyes can also contribute to both hollowing and the appearance of dark circles. I would usually treat the lack of volume with a soft hyaluronic acid filler like Restylane to add volume. I may combine the filler with platelet-rich plasma (PRP) which is a combination of wound healing and growth factors present in your blood, which is concentrated by extracting your blood, and spinning it in a centrifuge to concentrate the platelets. The platelets are contained in a clear, yellow plasma, which is PRP. PRP can help improve skin quality and thickness of the lower eyelid skin, stimulate collagen, and improve blood supply and circulation. I have found it to be a very effective treatment for improving under eye skin, and the appearance of dark circles.  Hyaluronic acid filler can be combined with PRP in the same syringe, and the two materials do work synergystically together, extending the effective life of both materials. I suggest you meet with qualified and experienced cosmetic surgeons who are experienced with eyelid procedures, as well as PRP. The eyes are a very delicate area, and under eye injections do carry risk, but these risks can be negligible if done by an expert. I hope you found this information helpful. Thank you for your question. 

Hello, and thank you for your question
I believe that you would be a great candidate for a procedure that I call Aesthetic Facial Balancing. A large part of my practice is using this procedure.  What this means is evaluating a patients face and bringing the features into harmony by making adjustments with either hyaluronic acid or fat.  The most important component of a fillers treatment is the practitioner administering it. I take filler and balance all features in your face from top to bottom to make them work together to 'unlock' your beauty. This procedure is not just a filler intervention augmenting the cheeks and lips, but as in overall, non surgical way to shape the face in a different way to create natural appearing results that will last for years.
I hope this helps!
Wishing you beautiful results,Dr. Rian Maercks M.D.

You may want to consider fillers for the under eye area.  They help by using volume to disguise under eye irregularities.  The procedure is done in the office and the results last up to one year.  See an expert injector in your area for a consultation to learn more.