Best Procedure to Remove Dark Circles and Under Eye Hollows?

i am 20 years old and have very bad hollows under the eyes one side is worse than the other and under my eyes it is very dark and gross its been bothering my whole life i really need help what is the best option?

Doctor Answers 7

Avoid Fillers have open fat grafting to correct Dark Circles and hollows under eyes

Correction of Dark Circles under Eyes is the most common procedure I do. It is very difficult if not impossible to inject a filler or fat into the correct position to plump a true dark circle under the eyes. Furthermore, the action of the Orbicularis Oculi muscle around the eye squeezes and displaces the filler down toward the cheek and most patients I have seen (many) complain that the filler injection made the dark circle worse.

I use a transconjunctival blepharoplasty incision(inside the eyelid) using the laser, release a structure called the Arcus Margunalis which tethers the eyelid skin to the bone and creates the depression which causes the shadow which is the dark circle under the eye. I then place a composite fat graft (a whole piece of fat) beneath the dark circle which plumps the dark circle and reduces the shadow. This has worked well in the majority of 2500 patients over the past 10 years.

Dark circles

Dark circles under the eyes can be 
1) skin pigmentation 
2) thin skin showing underlying blood vessels
3) prolapsed fat forward creating a shadow 
5) eye protruding forward 
6) combination of others 
These all require very different treatment. See an oculoplastic surgeon who can determine the cause and tailor a treatment plan specific for your problem. 

Treatment for Dark Circles and Lower Eye Hollows

There are a variety of causes for dark infraorbital circles.  One is excessive pigmentation that can be treated with a bleaching cream.  The second is the shadowing that takes place under lower lid bags, which can be improved with lower lid blepharoplasty.  The third is are tear troughs that can be more difficult to treat, including the injection of a filler.  The fourth is hypervascular skin that can be related to allergies, that are nearly impossible to treat.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 99 reviews

Lower Eyelid Hollows

The hollows can be treated with fillers. Be sure to consult someone who has extensive experience with this area. You should also not expect to have a totally satisfactory result. Partial correction may be all you can expect. If there is actual discoloration from pigmentation, you may find that skin bleaching helps a little too.

Hugh McLean, MD
Mississauga Plastic Surgeon
4.0 out of 5 stars 7 reviews

Dark circle and hollow under eye correction

  It's tough to make recommendations without a photo but IMHO if you have lower eyelid hollowing, the best option is a thin soft tissue filler like Restylane or Juvederm.  Fat is not reliable and can absorb unevenly leaving the thin skin, in this area, bumpy and unsightly.  The same can be said for thicker or permanent soft tissue fillers that are meant to be placed in places where there is a fatty layer with which to place them....the lower eyelid thin skin has no such layer and therefore these thicker (Radiesse, Perlane, Juvederm Ultra Plus) or permanent fillers (Artefil) should not be placed here.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 17 reviews

Treating under eye hollows

The best and safest procedure for reducing under eye hollows is usually fillers.

I urge patients to be very cautious about this area.

Fat injections can leave permanent lumpiness that is very difficult to correct.  We have seen many cases of patients dissatisfied with under eye eye fat injections.

Some hyaluronic acid fillers work better than others; I also urge patients to avoid semipermanent or permanent fillers for this area as well.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 127 reviews

Let's be honest, there is no way to remove dark circles.


Under eye hyaluronic acid filler represent the current best method of helping this dark circles.  The filler changes how light interacts with the skin and this change causes the dark circle to look much better.  These treatments can last well over a year.  This method works very well and for that reason, it is now recommended instead of laser or surgery for these issues.  However, everyone is a bit different and I encourage you to actually see cosmetic surgeons who specialize in treating the dark circle.  It is important to understand that your potential injector needs to be highly versed in the anatomy of the lower eyelid and midface.  Also these treatments are a bit of an art form and an adjustment of the service may be needed.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 22 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.