I’d like to know what’s the best treatment for my eye bags and dark circles?

Question

What’s the best treatment? Laser, radio frequency, blepharoplasty, hyaluronic acid?

Randal Haworth, MD, FACS · Answer

There are generally three methods to reduce undereye bags.
1. Utilizing peels, lasers or any other ablative or semi ablative techniques to stimulate new collagen growth. Though effective, most people want to have little to no downtime and in order to get a very effective result with which most patients would be extremely satisfied, these techniques will fall short of their stated goals. These techniques are wonderful if they are utilized in an appropriate strength. 
2. Carefully injecting a temporary filler (such as Belotero® or Restylane®) underneath the skin in hollow areas with magnification. This could be quite effective but does involve the risk of producing irregularities and lumps and will necessitate a certain amount of bruising. A permanent filler such as Bellafill ® or even a fat transfer utilizing purified fat from your body are also options.
 3. Performing a simple surgery under local anesthesia called a pinch blepharoplasty. In this operation, a small strip of skin is removed directly underneath the lower eyelash line and results in a nearly invisible scar. The recovery is very rapid (a couple of days) and involves one single stitch which is removed in five days. This approach is actually the least complicated in appropriate hands and will produce the most consistent and significant of results in reducing lower eyelid bags.

James Shire, MD · Answer

You are an ideal candidate for a Lower Lid Transcongunctival Blepharoplasty.  This technique is done with a small incision on the inside of the eyelid. There are no cuts on the outside and no stitches need on the inside. There is minimal swelling or bruising and no discomfort. I would not recommend lasers, RF, or fillers for you at this time.

Mehryar (Ray) Taban, MD, FACS · Answer

The ideal treatment for both under eye bags and hollowness (dark circles) is transconjunctival lower blepharoplasty with repositioning of the eye fat bags to the hollow area, with long-lasting natural results.

Rohit Seth, MD, MRCS(Ed), PhD · Answer

Thank you for your question. I see my colleague answered you already and on reading his answer, it is identical to what I would suggest. The best thing is to be seen by a surgeon who can assess the quality of your skin and determine the best treatment. Filler can work well if done correctly, but can make things worse if done too superficially. Laser treatments work well in rejuvenating the lower eyelids and are a good option. I hope this is of help to you BW

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon to determine which procedure is right for you. Keep in mind that blepharoplasty is a surgical procedure with a longer recovery time, while the other procedures are non-surgical with a shorter recovery time.
Best wishes,

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question. You would do well with either some filler which will help to reduce the hollowness or a laser treatment - whether it is radiofrequency or laser. Both give quite good results. It would be better to be assessed by a surgeon to assess the skin quality and overall laxity to determine if there is a surgical option as well. I usually assess in the clinic to determine which of the above three would be the best option for you.I hope this is of some help BW

Katrinka L. Heher, MD · Answer

You’re an ideal candidate for a  lower blepharoplasty.  This will erase the bags and circles and will last forever.  Filler would help to camouflage but the results would be less desirable. I would recommend seeing an oculoplastic specialist.  Best of luck!

Mehdi Sina, MD · Answer

Hi,An in person exam is critical to make the best recommendation. Eye bags are most effectively treated surgically. If the eye bags are minor, carefully placed dermal filler can be a very effective treatment. Your skin quality looks great in the photos, so there is no role for lasers or RF.Best,

Jane Olver, MBBS, FRCS · Answer

Thank you very much for posting your pictures. You have some congenital dark circles, small natural projection lower eyelid bags and a negative vector malar to eye. This means the orbital soft tissue and eye is lying partly in front of the vertical plane of the front of your cheek.I would suggest that you have an oculoplastic assessment by a Board Certified Ophthalmic Plastic and Reconstructive Surgeon (look up your local surgeon on the ASOPRS website if in USA or the BOPSS website if in UK). This is not with a view to surgery or laser, but for under eye dark circles / deep hollows / tear trough hollows treatment with hyaluronate filler.The principle is to gradually fill or build up the under eye area starting with the upper cheek to lid junction to correct the negative vector in a very natural looking way, then place a very small amount of the filler hyaluronate into the darker deeper hollows. This is usually done in a careful staged fashion so as not to overdo the fill but to keep you looking natural, with less hollows and eye bags. The hyaluronate is used to naturally disguise your eyeballs and hollows. Once treated the effects are long lasting with a top up anytime between one and three years in practice.

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You are asking what is the best treatment for your eye bags and dark circles.
I can certainly help guide you, even without a submitted photo for reference, and without the benefit of a physical exam. As an oculoplastic surgeon practicing in Manhattan and Long Island for over 20 years, I perform lower eyelid surgery to reduce eye bags every day in my practice, as well as non-surgical treatments to improve lower eyelid skin quality and texture.
Eye bags and dark circles under the eyes are actually treated as separate issues. Eye bags that are present all the time are caused by fat normally around the eyeball for cushioning that have pushed forward, creating these bulges. The definitive way to treat this is through a lower blepharoplasty to sculpt and remove the fat causing the puffiness. My preferred technique is transconjunctival blepharoplasty, where fat is sculpted and removed from behind the lower eyelid, without making an external incision. This avoids complications from the more common transcutaneous blepharoplasty, where the external incision below the eyelashes can compromise lower eyelid support structures, and cause the lower eyelids to pull down, otherwise known as lower eyelid retraction. Without an external incision, this method also looks completely natural, even from up close, like you’ve never had surgery, or ever had eye bags.
To treat dark circles, I often use platelet-rich plasma, or PRP, or sometimes a thermal treatment. PRP is the concentration of wound healing and growth factors present in your own blood. Your blood is drawn, then spun to separate the platelets from the dark components of the blood. This clear, yellowish serum is then injected into the lower eyelids to generate collagen, thicken thin eyelid skin, and increase blood supply and circulation to help remove iron deposits that may be causing the darkness. PRP can also help improve the pigment that is a common cause of dark circles. I may also consider a laser treatment to resurface the lower eyelid skin, as well as also trigger a collagen response.
It’s best to meet with a cosmetic surgeon who is very experienced with the eye area. The transconjunctival blepharoplasty method is a specialized technique not usually done by general plastic or cosmetic surgeons. Not all doctors are using PRP for the lower eyelids, but I have found it to be a very effective treatment in improving dark circles. Laser treatments are also effective in improving darkness under the eyes, so it’s important to ask your doctor about these specific treatments. I hope you found this information helpful. Thank you for your question.

I’d like to know what’s the best treatment for my eye bags and dark circles?

Answers (10)

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