Sunken Eyes and Dark Circles Treatment for Contact Lens User?

I am a 31-year-old Indian male. I have gotten contacts recently and I'm constanly being told I look tired because of my sunken eyes and my dark circles. I really want to treat this and want to know my options are. I have heard of Juvederm and Fat grafting. I would like not to do fat grafting at this time, however, if its the best option I will do it.

Doctor Answers 7

Restylane a better choice than Juvederm.

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Dear Mark

This is the risk of seeing better without glasses, it makes you want to look better as well.

Under eye Restylane is a fantastic option for your under eye area. However, you need about 2.5 ml of Restylane on each side. I think you risk being under treated with will lead to disappointment.

I very much prefer Restylane and Perlane for this application. Juvederm which is marketed as being "smooth" in my opinion is too runny for this application and seems to slip out of the lower eyelid space and accumulates at the top of the cheek.

It is impossible to achieve an acceptable result for this area with grafted fat because the tissue covering in the tear trough hollow is so minimal.

I encourage you to look at before and after filler results at my website:

Dr. Steinsapir

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

IPL can lighten eyelid skin color; Injectible fillers can darken eyelids

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A perfect result following filler injection can achieve a good result for the hollow eye. However very very few physicians can achieve and excellent result in my opinion.

Delicate eyelid skin often bleeds, forms bruises and the injected filler can show through as a lump. Some patients, ESPECIALLY dark skinned patients have reported permanent discoloration of the lower eyelids following bruising caused by filler injection in the lower eyelid.

I am not trying to scare you but I am honestly telling you the negative side of filler injection in the lower eyelids that I have seen in patients who end up in my office having had complications with filler injections done elesewhere.

My personal opinion is that the best solution for the characteristic hollow eye seen in patients of South Asian heredity is an arcus release and fat grafting (not fat injection as is commonly done but open fat grafting done under direct vision).

I have done many people from India and Pakistan over the years and have had uniformly excellent results.

I also use very specific IPL (Intense Pulsed Light) settings to lighten the dark skin.

See before and after Fat Grafting for eyes.

Injectable fillers work great for lower eyelid grooves.

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The good news is that your hollow lower eyelid appearance can be dramatically improved with injectable fillers. You should find an experienced, board-certified dermatologist or facial plastic surgeon with many favorable photos demonstrating great results.

Lower eyelid hollows are delicate, so MD credentials, experience, and photos are critical for you to get the result you want.

The bad news is that I'm not aware of any good treatments for darkness of the lower eyelid skin. It's likely caused by years of chronic nasal allergy, and I'm still searching for the magic serum to lighten this area.

Best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Tired Sunken Eyes and Dark Cirlces; What is the Best Treatment?

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Hi Mark,

Restylane is the best option to fill the hollows under your lower eyelids. It will help with the shadowing, and you will not look to be so tired. Juvederm sometimes swells a bit too much in this delicate area.

Fat is a good permanent solution when you are ready.

Seek out a physician who is well trained and experienced in this unforgiving area.

Good luck and be well. By the way, get some sleep, you look exhausted (just kidding).

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Dark Circles and Tear Troughs

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It's not unusual for patients to note periorbital aesthetic problems when they transition from eyeglasses to contact lens. The most likely explanation for this phenomena is that eyeglasses hide these problems while contacts expose them.

Nevertheless, dark circles beneath the eyes and tear trough deformities are two of the most difficult problems treated by plastic surgeons. These problems occur for a variety of reasons and the treatment is entirely dependent upon the cause.

In this particular case, it's virtually impossible to make treatment recommendations without pictures or a physical examination. In some cases, fat pads can accentuate hollows beneath the eyes and cast shadows that give the appearance of dark circles under the eyes. Under these circumstances, lower eyelid blepharoplasty with fat re-positioning is probably appropriate.

In other cases, tear trough deformities may be the problem. Under these circumstances, the injection of hyaluronic acid fillers may be appropriate. Finally, pigmentation changes may be related to allergies and other medical problems. When this situation arises, treatment with bleaching creams may be indicated.

It's appropriate for patients with these changes to consult a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Dark circles under the eyes

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Unfortunately, there is no great solution for your problem. Fillers would help somewhat hide the shadow beneath the eyes, but not to a great degree. Your skin is darker in that region and Hydroquinone 4% would lessen the  hyperpigmentation. Hopefully, this combination approach gives you a satisfactory appearance. 

Very difficult to treat but can be improved

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I believe with injection of fillers in the tear trough, your dark circles can be improved. There is no permanent treatment for dark circles. So you can just improve them. Also there are some products that can decrease the pigmentation in the area along with PRP that can help with this area.    

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.