Dark circles due to pigmentation or hollowness or both. Is filler or fat grafting only the solution? (photos)

There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Hello, Thanks for sharing your pictures. Fat grafting is a good option in your case to partially restore the volume loss to your under eye region. As you have mentioned, there are complications. Kindly meet a board certified occuloplastic surgeon or a plastic surgeon who will guide you better. 

Thank you for sharing your question. Darkness under the eyes can be due to hollowing, pigmentation and/or prominent vasculature. Fillers and laser skin resurfacing are usually the best options. See an experienced Oculoplastic Surgeon for comprehensive evaluation and discussion of treatment options.Good luck,

Hi and thank you for sharing your pictures and concerns. The issue you are describing is extremely common, and although there is not one standard protocol amongst providers to address it, there are certainly many different treatments available to help dramatically improve the appearance of dark circles and under eye hollows. As others have mentioned, you have to address both the pigment and the volume deficiency in the area that is resulting in what you're seeing. In your skin type, pigment can be addressed with topical creams/ointment as well as PRP (platelet-rich plasma) injections and certain light/laser devices to help lighten the skin. Volume replacement can be accomplished with a wide variety of fillers, collagen stimulators or your own fat. Although there are risks with any procedure, in experienced and well-trained hands these procedures are generally very safe. An in-person consultation with a well-reviewed, qualified facial specialist is the next move for you! Hope that helped! Best, Dr. Roy

Fillers often work well to improve the look of under eye hollowness and can improve the look of dark circles as well.  There are risks to every procedure, but fillers carry a low risk and many patients love the results.  I encourage you to visit with an experienced injector in your area to learn more.