Would lower blepharoplasty get rid of my dark under eye circles? (photos)

Question

I have always had under eye circles but I’m noticing the older I get the worse they get. I’m 23 but in a short matter of time, my under eye circles have really gotten noticeable and at this point even concealer is struggling to cover them. I have tried to get under eye filler before but the doctor advised against it because my under eye trough isn’t necessarily that deep as it is dark. Would lower blepharoplasty correct my under eye circles?

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. Because of your age and lack of excess skin, you’re unlikely to be a candidate for blepharoplasty surgery at this time. However, hyaluronic acid dermal fillers are ideal for treating under-eye discoloration. 
When injected into the under-eye and upper cheek, fillers can soften this area to allow light to be naturally reflected,  making the eyes appear more awake and refreshed. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can assess your concern and suggest the best treatment option for you.

Nelson Lee Novick, MD · Answer

While it is true that filler may not significantly improve the under-eye region, it is important to be aware that the upper cheek region is an important support for the under-eyes and when there is volume deficit the appearance of hollows, tear troughs and dark circles is accentuated. You may profit from the use of a robust HA filler in upper medial cheek region. This then may be followed by the use of a series of superficial peels for the under eyes accompanied by the at-home application of prescription strength bleaching creams. You would be wise to consult with a board certified cosmetic dermatologist to discuss these options.  Be wary of claims for this or that relatively expensive light or energy-based, as these are backed far more by marketing hype than hard science.  Best of luck.

Robert T. Buchanan, MD (retired) · Answer

You have a congenital area of volume deficit, probably just above the muscles originating from the bone below the orbital rim. Treatment is injection with a heavy filler like Juvederm Voluma right on the bone below the orbital ligament. Make sure you see an expert who understands the problem and this technique.

Would lower blepharoplasty get rid of my dark under eye circles? (photos)

Answers (4)

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