I Am from Indian Descent and Have Severe Dark Circles and Sunken Eye Problem. Will Restylane Help? (photo)

You have a very difficult problem to treat. Dark circles can be from shadowing due to volume loss, thinness of the skin revealing the blood vessels below, or dark pigmentation of the skin.  I like to spread the skin to flatten it and remove the shadowing effect to see if the skin is actually pigmented causing the darkness, or if it is just from the shadowing. This can sometimes predict how much of an improvement there will be with fillers.  We can get some improvement using fillers like Restylane or Belotero. The volume needed is hard to predict, however most of the time 1 syringe (total) is adequate. If the darkness is due to skin pigmentation, you may also need a skin care program to help. I would consider doing that before doing laser treatments.

You can certainly benefit from injecting Restylane to the tear troughs, this filler is a lot smoother to be used for thin skin around the eyes, this will also help lighten the dark area IF the hollowness from the eyes is creating a shadow. 

 

 

Restylane for the tear trough can yield a fantastic result when the treatment is performed properly by an experienced and board certified physician.  In general, there are numerous causes for dark circles under the eyes.  While lack of sleep is certainly one of them, other common causes include: pigmentation irregularities, sun exposure, visible blood vessels, stress, allergies, atopic dermatitis, pseudoherniation (outpouching) of fat from the eyelid, and heredity, to name a few.  Fat can cause the appearance of dark circles, which can be corrected by fat repositioning blepharoplasty. Some pigment can be treated with laser and/or bleaching creams.  However, if it is too deep the treatment will not be effective.  Surgery can not correct dark circles due to every cause, but it will correct dark circles that are due to the aging process.  I would recommend an in-person consult with a board certified physician. They will be able to examine you in person and provide recommendations based on your individual needs. I hope this helps, and good luck! 

Tear troughs, hollows, and dark circles are common problems of the lower lids. It has become standard practice to treat this region with lighter weight fillers, like Juvederm or Restylane, to lift, straighten, and contour this region. Occasionally, if fillers are inadvertently placed too superficially, a bluish discoloration related to light scattering (a phenomenon known as the Tyndall effect) can occur, which can actually make the dark circles more prominent. Belotero, a new hyaluronic acid product, has been manufactured to avoid this. However, I have found that the addition of a tiny amount of Radiesse, a whitish-colored filler, to Juvederm UltraXC, to be an excellent way of treating tear troughs and hollows and lightening existing dark circles. However, only an experienced, board certified aesthetic dermatology or plastic surgeon injector should attempt to treat this area in this fashion.

I would strongly advise against any laser treatments or other resurfacing treatments, such as strong peels, to treat the under eye dark circles. In a person of color, this may result in post-inflammatory hyperpigmentation that can actually worsen the appearance for a protracted period of time. 

From your photo you've provided, it seems you have some volume loss in your tear troughs and Restylane appropriately injected in the right amount, will help with that area. As far as the dark circles, it's difficult to say if those will go away-certainly using filler will help lessen the severity of the trough, but doesn't always correct the pigmentation.

Dear Pgk500,


Restylane can help make the dark circles lighter, but may not remove them all together

Your other option includes fat transfer which may help replace lost volume and address the shadows

It is a good place to start, then we can explore other options


Best regards,

Nima Shemirani

Yes, you are a candidate for filler injection in the lower eyelid hollow area. Use either Restylane or Belotero.  The amount of filler differs on each person.  It almost always one syringe or less, total for both eyes.

I completely agree with Dr. Goldberger.  Restylane will be beneficial for your appearance in the under eye area.  Be sure you go to an experienced injector.

 

 

Dr. Grant Stevens        Marina Plastic Surgery Associates    Marina del Rey, CA         The Institute

 

Because dark circles under the eyes are caused by more than one factor (aging with fat pad sagging leading to hollowness, too much pigmentation,  the color of underlying blood vessels showing through the thin skin, and skin conditions such as eczema), more than one treatment can help.  A filler (I recommend hyaluronic acid since it's reversible if you don't like it) can help--I would start with a one cc syringe.  However, I don't recommend doing it yourself or putting it "in each eye" the way your question reads.

Gentle laser treatments to shrink blood vessels, lessen pigment and stimulate collagen can help.  It is important to see someone with experience in treating your skin type.  

Light chemical peels may help very slightly.  Topical creams will sometimes help a little bit.

 

I would use Restylane to soften the sunken appearance. I would leave how much up to the injector. I probably would not use more than a total of 1cc but it is hard to be sure rom a photo. I agree with others who recommended eye creams with some good antioxidants, arnica, vitamin K and a retinoid to lighten the area some but that ids the hard part.