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Lower blepharoplasty did not help. What can be done about dark circles under eyes? (Photos)

Realself33205Dec 13, 2025
I had lower eyelid blepharoplasty done in 2021. Its main effect was reduction of bags under my eyes, but had no effect on my chief complaint, which is dark circles under my eyes. After the surgery when I asked the surgeon what could be done, he said “nothing can be done about that”, and that I should consult with a dermatologist. Dermatologist prescribed Tri-luma which I used for 3 months, night time, and did nothing at all. Another dermatologist prescribed 15% azelaic acid on top of it, and I did not notice any difference either. I consulted with another oculoplastic surgeon, and he said, "that is the color of the skin and fat injection under it will not change the color and there is nothing I can do". So i am confused about what is the actual diagnosis and what could be done. If it is the color of the skin, then why nothing is working for it? is there anything that could be done? Thanks

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From board-certified doctors and trusted medical professionals
Dr. Nelson Lee Novick, MD
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Dr. Nelson Lee Novick, MD
Dermatologic Surgeon, Board Certified in Dermatology
4.7 | 119 Reviews
Answered on Dec 16, 2025
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Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For addressing eye bags and creases, I would recommend upper blepharoplasty, which is a surgical procedure designed to rejuvenate the upper eyelids...

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Nelson Lee Novick, MD

At least from the photo, this would be an appropriate issue to treat with simple electrocautery following local anesthetic to numb the skin. The remnant should shrink once and for all with the proper application of the electrocautery. I have actually treated active chalazions in this fashion...

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Thank you for your inquiry! We would love to sit down with you to discuss your concerns. An Blepharoplasty removes the fat pads and excess skin. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

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The syndrome is a consequence of an unstructured upper blepharoplasty. It includes upper eyelid ptosis or heaviness, poorly formed high or absent upper eyelid crease, crepey eyelid skin, compensatory eyebrow elevation, and lash ptosis. The syndrome is a spectrum and often affects eyelids...

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Tania Hassanzadeh, MD

Hi there, Thank you for providing detailed medical history and photos! While I cannot see enough of your lower eyelid/tear trough in your bottom photo (which I assume is after surgery) to comment on hollowness, it does seem to me that you have a thickened eyelid muscle. This is called the...

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