Dark Under Eye Circles After Lower Eye Lift?

Question

After having a lower eyelift, I now have very dark circles 10 weeks post op. Is this permament, and why did this happen? Now I HAVE TO wear concealer and did nto have this before the lift.

Nelson Lee Novick, MD · Answer

There are a number of reasons for dark circles under the eyes. Lack of sleep, allergies, pigmentary abnormalities, and postoperative bruising under the skin have all been described as possible causes. 

	However, the first-time appearance and persistence of  hollowness and dark circles under the eyes several months following lower lid blepharoplasty surgery suggests that perhaps too much fat was removed at the time of surgery leaving the delicate thin skin of the lower lid to rest over the dark structures immediately below it and to reflect the underlying darkness.

	The use of fillers, such as Juvederm Ultra XC combined with a small amount of a whitish colored calcium-based filler, Radiesse, injected into the darkened, hollowed areas of the lower lid can restore both the lost volume to the region and lighten the color. It takes only about ten minutes to perform and, in fact, is a nonsurgical approach often used these days in lieu of eyelid surgery to treat crinkles, tear troughs, hollows and dark circles

A.J. Amadi, MD · Answer

A photo would be helpful, but an in-person evaluation is more valuable. In general, there are three reasons why the skin around the eyes can be [or seem] darker:

	1. The thin eyelid skin allows the darker muscle underneath to show

	2. The hollowness around the eyes can create a shadow effect that exacerbates darkness

	3. Skin pigmentation [sometimes from blood products from bruising]  If it is blood    product pigmentation, it could last months to improve.

	Depending on which of the above is the issue, different modalities may be helpful [time, fillers, laser resurfacing, concealer etc].

	If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

Patrick Flaharty, MD FAACS · Answer

The most common cause of dark circles under the lower eyelids is hollowness from fat loss over the orbital rim.  This hollowness causes shadowing leading to the appearance of dark circles.  In my experience fillers are the best solution for this problem.  Using topical numbing gel applied to the skin restylane can be delicately placed and molded into this depression instantly correcting the hollowness and greatly improving the appearance of the dark circles.

	Removal of lower eyelid fat pockets during eyelid surgery can reduce the bags but does not help the dark circles which typically occur below the lower eyelid fat pockets.  Certainly bruising after eyelid surgery can cause darkness under the eyes from pooled blood products but most of this should have resolved after 10 weeks.  An examination can quickly determine the cause of your dark circles and the best course of action.

Robert Brueck, MD · Answer

This can happen and may be due to bruising from your surgery that can take time to correct.It coiuld be due to little vessels or increased pigmentation.This can be treated with some skin care lines or a lite peel.

Edward O. Terino, MD · Answer

In my 35 yr experience I have never seen persistence under the eyes for longer than a month or two and even that is unusual.there are two exceptions to the rule: 1) if there is a lot of bleeding and trauma during surgery or maybe the patient has some high blood pressure or did during the procedure.2) when fat is removed from the lower orbit during lower blepharoplasty and especially if removal is excessive---then a postoperative hollwness and shadowy dark look can occur permanently. That is why good surgeons do not remove fat any longer.

	Usually the persistent dark skin problem after bruising or bleeding in the lower lid is seen mostly in darker skin ,hair, and eye color people.

Amiya Prasad, MD - Account Suspended · Answer

Dark circles under the eyes after eyelid surgery, there can be some temporary darkening of the skin (particularly for people who tan easily). Dark circles below the eyes are a combination of ethnic pigmentation, skin thickness, vascularity, and other factors such as allergies. In my practice in New York, I advise my patients after blepharoplasty to use an under eye cream with sunblock and typically the skin color returns to it's normal pigmentation. I even developed a medical-grade skin care line in helping my patients maintain their skin after surgery, including Eye Rescue and an antioxidant sunscreen.

Dark Under Eye Circles After Lower Eye Lift?

Answers (6)

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