Best Treatments for Double Undereye Circles?

I am a 45-year-old woman. The dark circles have almost become two circles under each eye, which really makes me look double tired. People often ask me if I'm tired or sick, and makeup has been unable to cover these I am fair-skinned and would be glad to send photos to see what you would advise for treatment. My dad also had circles when he died at 64, but his were not as obvious as mine. What are my dark circles treatment options, and how much would it cost for this?

Doctor Answers 3

Surgical and non-surgical procedures options to improve undereye circles

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Too tired,

Looking at your photograph, I would recommend two different approaches based on your comfort level. The first non-surgical approach would be to fill in the hollow or shadow that is below the circle (or lower lid bags) with an injectable hyaluronic acid filler such as Restylane. This would improve that aspect and help mask the excess puffiness which is present above it. However, it would not address the actual puffy area. The downtime is minimal other than an occasional bruise that may last around a week.

The second option, which would give a more dramatic improvement, is a lower lid transconjunctival blepharoplasty (no visible scar) in combination with a facial fat transfer/grafting to remove the herniated fat causing some of the puffiness and filling in the shadow or hollow with your own fat from your abdomen or thighs. This has around a two-week period of bruising and swelling and may not correct the entire problem as you may have skin swelling/laxity in the area in addition.

It is difficult to tell with the picture. A thorough evaluation by a qualified facial plastic or plastic surgeon is recommended to evaluate what option is best for you. Best regards.

Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

There is no good treatment for dark circles under your eyes.

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 Lower eyelid dark circles are usually irreversible, and are due to years of chronic nasal allergy. 

The lower eyelid bags can be minimized by using an injectable filler to the groove just beneath the bulge.

Good luck, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 432 reviews

Filling with Restylane

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Dear Too

Agree, these are big dark circles.

You have several options.

Surgically, the best approach here is an arcus marginalis release where the lower eyelid fat is conserved and rotated as living fat grafts into the top of the cheek.

Standard eyelid surgery will simply hollow out the lower eyelids and you will be left with a very deep dark circle.

Non-surgically filling the under eye hollow is very effective. For this, you need about 2.5 mililiters under each eye or a total of 5 mililiters of Restylane. This treatment is good for a year or more.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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