I Have Dark Undereye Hollows. Would Fillers or Blepharoplasty Be Right for Me? (photo)

I have always had dark undereye circles which have bothered me. When I smile the hollowness under my eyes is marked. The darkness also seems to run up the inside corners of my eyes. I am often told that I look tired or angry, usually when I feel fine and am relaxed. I'm only 27 and I'm tired of being told I look tired! I've heard Restylane or other fillers can be used under the eye, but I know that blepharoplasty could be another option. What should I do? Thanks in advance for responding.

Doctor Answers 6

Restylane for the tear trough

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears you may benefit from filler in the tear trough, and the best option can be determined for you following an in-person exam. I like to use Restylane in this area, as is yields a great result. It is important that you seek the advice of a board certified specialist when looking to have filler in this area, as it requires a great amount of skill and experience. I hope this helps, and I wish you the best of luck. 

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Lower Eyelid Surgery or Fillers for Eyelid Bags and Tear Troughs

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your question and the photos. Either soft tissue fillers or fat grafting can be a great option for hollowness and dark circles under the eyes, particularly in younger patients. Lower eyelid lift or fat bag removal (blepharoplasty) is not the best option for younger patients with normal eyelid laxity and minimal fat bags. In my practice, I use Restylane for tear-troughs. This treatment lasts up to 9 months and dissolves slowly. Fat grafting may result in a longer or even permanent correction, but is associated with potential complications (e.g., long-term swelling) and must be repeated due to poor graft survival in about 1/3 of patients. Fillers offer a great way to "try out" the treatment before committing to a longer-term and more invasive option. Best of luck!

Restylane and under eye treatment

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on the photo's you've provided, you would likely be a good candidate for a hyaluronic acid based filler (Restylane, Juvederm, Belotero). It's difficult to determine what surgical option would be your best option without seeing you in person.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Dark circles infraorbital rim

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Quick opinion before surgery!

Restylane to the tear troughs yes!

Infraorbital rim autologous fat transfer yes!

Lower blepharoplasty No!

Kind regards

I Have Dark Undereye Hollows. Would Fillers or Blepharoplasty Be Right for Me?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

   Restylane to the tear troughs would be a good choice of filler and reduce the under eye burden seen in your pictures.  There are other techniques that can be utlilized as well, but I would start with Restylane for this.  Kenneth Hughes, MD Los Angeles, CA

Under eye fillers

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is a lot of hollowing in the under eye area and I think you would benefit from lower eyelid Restylane injections. That being said, there appears to be very little soft tissue between the skin and the underlying bone which makes the treatment more difficult from a technical perspective. Make sure you go to someone who is very experienced in this procedure.  

Traditional blepharoplasty procedures will not help your condition. Some surgeons add fat grafts at the time of blepharoplasty surgery, which may help, but my preference would be to avoid surgery all together and treat you with filler injections. Best wishes.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
4.9 out of 5 stars 182 reviews

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.