Which Fillers Would be Best for Dark Circles Under Eyes and Facial Volume Loss?

Hi there, Im 26 Spanish girl, and feel like Im rapidly losing facial volume. I have hereditary dark circles now getting darker, complexion is getting darker and duller, with pillow lines running from my cheeks and flat cheeks and a flat cheek profile. I still have active acne and marks. Looking to solve my concerns, but have mixed feelings after reading some fraxel and filler horror stories! Would really appreciate recommendations on safest procedures for me! Thanks in advance.

Doctor Answers 2

Frequent causes of dark circles under the eyes

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  Dark circles under the eyes can start very early in life and they can make you look tired even after a good nights sleep.  Tired-looking eyes can be the result of too much skin, excess fat, retained fluid or bulging muscles.

  Given your young age and I would agree with you that there is likely a hereditary component.  Looking at the photographs you provided I would suggest that there is a combination of phenomena contributing to the dark circles under your eyes. 

  It appears as if you are retaining some fluid in the tissues around your lower lids.  A history of circles that are worse in the morning, or fluctuate in severity throughout the week would be consistent with retained edema.  This can be hereditary or be caused by allergies or sinus disorders.  If you have symptoms allergies or sinusitis, improving these conditions may improve the discoloration.

 The color of your skin is also contributing to the severity of the darkness under your eyes. The increased pigmentation of the lower eyelid skin may be improved with a very short course of a skin lightening agent such as hydroquinone 4%.  This agent alone will not fully correct the discoloration, but could enhance more definitive treatments. 

  And finally, there is a degree of volume loss with descent of your cheek fat pads which typically line the lower part of the eye socket.  Bulging of the lower eyelids and cheek fat pads reflects light, causing a shadow to occur in between these areas.   For someone your age a good initial treatment would be to try a filler, such as Restylane. 

  When placed by a properly trained professional, injectables are a safe and effective way to restore volume under your eyes.  “Horror stories” are most commonly the result of an attempt to save money by going to a provider in the area that shouldn’t be using injectables.  I cannot stress enough that just finding the lowest price in town does not make it the best deal.   Facial Plastic Surgeons, Dermatologists, and Plastic Surgeons should be competent to address your concerns.

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

Under eye volume loss

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From your pictures, it appears you have volume loss under the yes, producing a tear trough deformity.  There is also some pigment change to the skin in that area.  The filler I like for that area is Restylane placed with a very small 32g needle.  This will recontour the hollowness and make the lid flat with the underlying cheek.  It will not change the skin pigment, but helps with the light shadowing from the contour deformity.  Now when you put your makeup on, it will look much inproved.  Laser will not change this type of issue, volume is the answer here.  Hope this was helpful.

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon
4.9 out of 5 stars 32 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.