Lower lid blepharoplasty to correct circles
It is difficult to see exactly where the problem lies without a physical examination however it does appear you have a small amount of fat protruding from the lower eyelid
region. This is best removed by a transcongetival lower lid blepharoplasty. The fat is removed from inside the eyelid and no skin or muscle is taken from the area. It is as important what you take out as what you leave in. You do not want a hollow appearance under the eye. This is a hereditary condition in many patients and I have done many blepharoplastys on "moms" and then their children ten years later. Since you are only twenty years old you have plenty of time to consult with many experts and get several opinions. Fillers in the region may give you the desired effect you are looking for and do surgery further down the road. Juvederm and Restylane are the best fillers for this region. I would stay away from Radiesse I see many unhappy patients from other surgeons when this is injected in the lower eyelid region. Best regards!
Treatment for Dark Circles Under Eyes Caused by Hollows
I would recommend carefully placed Restylane, likely only about 0.5cc (half of a syringe) on each side. The Restylane injections in this delicate and unforgiving area should only be performed by experienced physicians.
If you are still dissatisfied with your eyelids, you can always have blepharoplasty in the future.
Now on the otherhand for your Mom......just kidding.
Good luck and be well.
A lot of things go into making your lower eyelid issues
I would be interested to know what flavor cosmetic surgeon you saw.
Having said that, some cosmetic surgeons have the "big cutter' mentality: every thing needs to be done with the knife. You do have a tiny amount of lower eyelid fullness that is the results of orbital fat. This is what is addressed with lower eyelid surgery. A more sophisticated approach conserves this fat and moves in into the top of the cheek as a living graft. This is called an arcus marginalis release. However, your lower eyelid fullness is small and your tear trough hollow is large, so the benefit you will get from this procedure will be modest.
Filling your lower eyelid with Restylane is a non-surgical treatment that will likely help you for more than a year, perhaps two years. You need about three 1 milliliter syringes of Restylane (1.5 on each side). In my West Los Angeles office that service would cost you about what you were quoted for surgery. I suspect that in Ohio, you are likely to get that filler service for much less than the West Los Angeles price.
I think fat grafts and other permanent fillers are a big mistake for the lower eyelid.
In Ohio, I can recommend Jill Foster, M.D., without reservation. She is an oculoplastic surgeon in Columbus. She does both eyelid surgery and periocular filler treatments. Additional eye plastic surgeons in your area can be found at the website for the American Society for Ophthalmic Plastic and Reconstructive Surgery: www.ASOPRS.org.
Treatment for dark circles under the eyes
Darkening around the eyes can be due to:
- thinning of the skin with increasing visibility of the underlying tissues
- shadows created by lax tissues (like bulging of fat into the lower eyelid that creates a shadow under the bulge) or deep set eyes
- generalized increased pigmentation seen in dark complexioned people of Mediterranean or Middle Eastern descent
- localized small blotches of increased skin pigmentation - age spots- due to chronic sun exposure & aging
You can find out which category applies by the difference in the area on direct versus non direct lighting. If you shine a light perpendicular to the skin surface and the darkness goes away then it is a shadow problem (i.e. number 2).
1 is best treated with camouflage creams & sometimes surgery. 2 can be improved with surgery (removal, repositioning or adding fat). 3 can not be changed. 4 may be amenable to CO2 or Yag or Ruby or Alexandrite laser. unless it is melasma which should only be treated with skin bleaching creams.
It is hard to say without a face to face examination but from the photos it looks like you are in category 2. Therefore that surgeon's recommendation is not too far off the mark. It may be better to reposition at least some of the fat over the boney rim under the eye in order to avoid a hollowed out appearance after surgery.
Options for lower eyelid circles
It is difficult to tell from the photos. However, the use of fillers could be considered in your condition. If you like the result , you could proceed to more long term fillers such as autologous fat.
It is likely the surgeon recommended a transconjuntival lower lid blepharoplasty in which the fat is removed from inside the eyelid with no external incision.