Which is better for under eye bags? Ultherapy or Radio Frequency? Also will either of these help with dark circles?

Question

I look very young for my age (45) but have always had dark circles and bags, they are gradually getting worse as I get older. Also have hypothyroidism which I'm sure doesn't help. Trying to avoid fillers ...is there anything else you can recommend?

Jason Emer, MD · Answer

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly from emeragecosmetics.com see eye rolling package for weekly treatment) should be started now.  visit emeragecosmetics.com where we ship medical grade skincare all over the world AND do free virtual skincare consults daily. Proceeds benefit BLM and LGBTQ+ charities/organizations.
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 be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Kimberly Butterwick, MD · Answer

While filler is often the best option for treating dark circles from hollow eyes, you can tighten the skin around the eyes using a nonsurgical skin tightening treatment like Thermage. This device has a specific tip for the eye area, and it delivers radiofrequency energy into the dermal structure, where it heats the underlying tissue to stimulate collagen production in the area. The new collagen adds subtle fullness to the area while smoothing and firming the skin. It can be used safely on both the upper and lower lids and has no downtime. Laser resurfacing is sometimes an excellent option as well, but the power of a fully ablative CO2 laser is needed. This requires 7 – 10 days of downtime but results in excellent, long-lasting tightening in this area as well as improvement in color. I encourage you to schedule a consultation with an experienced, board-certified dermatologist who can assess you in person and create a customized treatment plan based on your precise needs and goals.

John J. Martin, Jr., MD · Answer

Ulthera should not be used inside the orbital rim which is where the fat is located.  RF may help to tighten the skin and might make them less noticeable.  Filler put in below the fat pads can often make the area appear smoother.  Or surgery is always a good option for prominent fat pads.

Which is better for under eye bags? Ultherapy or Radio Frequency? Also will either of these help with dark circles?

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