28 & dark circles since 15, polynucleotides or filler for my dark circles? (Photos)

Question

28 and have had dark circles since I was 15 (which suddenly appeared after struggling with insomnia) and have never gone away. There is hollowness but it’s the discoloration (bordering more red-pink than purple) which bothers me most. I had three sessions of PRP/PRF last year but it didn’t do much. I’ve been hearing a lot about polynucleotides and am wondering if it’s worth trying, or even with the risks of under eye filler, if that is a better option in my case?

Anna Chacon, MD, FAAD · Answer

It's understandable that you're seeking effective treatment options for your long-standing dark circles. Both polynucleotides and fillers are potential treatments, but they address different aspects of the problem and come with their own benefits and risks. Let's break down each option:

Polynucleotides
Polynucleotides are relatively new in the aesthetic field. They are derived from DNA and are believed to help with tissue regeneration and repair, improving skin texture and health. Here are some potential benefits and considerations:
- **Benefits**:
  - Can improve skin quality and elasticity.
  - May help with pigmentation issues to some extent by promoting healthier skin.
  - Non-invasive with minimal downtime.

- **Considerations**:
  - Limited long-term data on efficacy and safety.
  - May require multiple sessions for noticeable results.
  - Results can vary significantly between individuals.

Under-Eye Fillers
Fillers, typically hyaluronic acid-based, are more commonly used for addressing hollowness and volume loss under the eyes. Here are the benefits and considerations:
- **Benefits**:
  - Immediate improvement in under-eye hollowness, which can reduce the appearance of dark circles.
  - Long track record of use with established safety profiles when performed by experienced practitioners.
  - Results can last from several months to over a year, depending on the filler used.

- **Considerations**:
  - Risk of complications such as swelling, bruising, or, rarely, more severe issues like vascular occlusion.
  - May not directly address pigmentation; best for hollowness.
  - Requires skilled and experienced practitioners to minimize risks and achieve natural-looking results.

Recommendations
Given your description of both hollowness and discoloration, a combination approach might be most beneficial:
1. **Consultation with a Dermatologist or Aesthetic Specialist**: This is crucial to tailor the treatment to your specific needs. They can assess the underlying causes of your dark circles and recommend the best course of action.
2. **Combination Treatments**:
   - **Fillers** can address the hollowness, potentially reducing the shadowing effect that exacerbates dark circles.
   - **Polynucleotides** or other skin rejuvenation treatments like microneedling with PRP, laser therapy, or chemical peels could help with the discoloration.

Both polynucleotides and fillers have their merits, but their effectiveness can vary based on individual circumstances. A thorough consultation with a qualified professional is essential to determine the best approach for your dark circles. They might suggest a combination of treatments to address both the hollowness and discoloration effectively.

Camille Cash, MD · Answer

From the submitted photos it appears you are a candidate for under eye filler.  This can help improve the hollowness under the eye and create a smoother transition from the under eye to the cheek.  See an expert injector for treatment.

Leonard Grossman, MD · Answer

What appears to be a dark circle under the eye area is really a shadow that is being casted by your eye itself. If you touch it, it’s bone Yet it looks like a bag. The reason for this is a hereditary lack of volume in the upper portion of the cheek and lower eyelid. This is usually hereditary condition inherited from your father. I would not recommend doing any fillers because they invariably lead to problems, fat grafting on the other hand will provide you with a phenomenal solution to the problem which should be natural and permanent, as long as it’s done by an expert Plastic surgeon in Fat grafting techniques. I hope this helps and good luck from Leonard Grossman M.D. organic Plastic Surgery

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