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

I would like to know if I need combination of restylane and laser to get rid of dark circles and sunken eyes problem.How much restylane should I inject in each eye? Any help is appreciated.:) Thankyou!

Doctor Answers 15

Tear troughs and dark circles under the eyes.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Deep placement of a hyaluronic such as Restylane will definitely help to soften the deep troughs on the inner aspect of the lower orbital rim.  Don't let anyone overfill the area as hyaluronics pull moisture into the gel matrix and you don't want to overdo the fill.  The dark circle are another challenge.  Most of this is due to vascular congestion and leakage of red cells out into the surrounding superificial tissues.  Wouldn't recommend laser, but would strongly encourage you explore eye creams that contain Retinols, caffeine, green tea polyphenols, arnica and Vitamin K.   Topix Pharmaceuticals make several products for the eyes that have these and my patients love them

Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Dark Circles?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dark circles under the eyes are most often caused by volume loss, shadowing, and/or dark pigmentation. Plus, the thin skin in this location tends to transmit darker colors like the bluish discoloration of blood vessels under the skin. This makes the under eye area a challenge with regard to dark circles.  Darker skinned individuals are of no exception. The key to determining which of these factors is playing the dominant role in creating your dark circles is the Physical Exam.  See a doctor who can examine you carefully in good light, and at different angles. Palpation of the skin that can simulate tightening or volume replenishment is also very useful. Thin fillers like Restylane can be very useful to add volume and correct tear troughs, but subtle is best. I usually start with 1 syringe split between the 2 lower eyelids and then ask patients to return 2-3 weeks later for an interval exam.  Occasionally, more product is helpful. Don't get discouraged, but know that  various treatments (fillers, peels, skin care, fat grafting) are sometimes required for ideal benefit. -Dr. Capone

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Treating under eye dark circles can be challenging!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

I Am from Indian Descent and Have Severe Dark Circles and Sunken Eye Problem.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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. 



Improving the appearance of dark circles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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! 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Restylane to Tear Troughs.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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


Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

A Small Amount of Radiesse Combined With Belotero Balance Works Well For Tear Troughs, Hollows and Dark Circles Under the Eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Restylane and dark circles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Restylane under the eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Dark circles often require combination treatments

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.


Margaret Weiss, MD
Baltimore Dermatologic Surgeon
3.9 out of 5 stars 8 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.