Severe dark circles - Am I a candidate for fillers? (photo)

Question

Hi , I am from India. I have these severe dark circles haunting me for years. I am currently going through Pico lasers under eye , it's not helping much. Am I candidate for fillers . Will it help ? What should be plan of treatment

Jeffrey H. Spiegel, MD · Answer

In short,  the answer yes! Under eye fillers, AKA tear trough fillers, help undo under eye concovaties as a result of volume loss. As such, the light will bounce off better and the dark circles will improve significantly. In addition you may want to consider brightening products and laser procedures to help lighten and tighten the under eye skin. In Boston we have a diverse population, including people of East Indian and Middle Eastern decend and we've shown this treatment plan to be extremely helpful.

Ajaya Kashyap, MD · Answer

Thank you for your query. In your situation I usually do carboxytherapy and nano fat grafting with good results. Fillers do help with under-eye  hollows but nano fat grafting along with PRP improves the skin as well. Carboxytherapy further improves the pigmentation. Please find an experienced board. Certified Plastic surgeon who can examine you and help you with wall your concerns. All the best!

Anna Chacon, MD, FAAD · Answer

Hello, and thank you for reaching out with your concerns about severe dark circles. It's understandable that you're seeking effective solutions, especially if previous treatments like Pico lasers have not provided the desired results. Here's some information that might help you decide on the next steps:

Understanding Dark Circles:

Dark circles can result from various factors, including genetics, pigmentation, thin skin, and volume loss under the eyes. Identifying the primary cause is crucial for effective treatment.
Are You a Candidate for Fillers?

Volume Loss: If your dark circles are primarily due to volume loss or deep tear troughs, dermal fillers such as hyaluronic acid-based fillers can be effective in providing a smoother, more youthful appearance by reducing shadowing.
Skin Type and Pigmentation: For individuals with darker skin tones, like many from South Asia, pigmentation can also play a significant role. Fillers might not address pigmentation issues, so a combination approach may be necessary.
Potential Benefits of Fillers:

Fillers can help restore volume and reduce the appearance of hollowness, which might improve the overall appearance of dark circles. They should be administered by a qualified and experienced professional to ensure safety and effectiveness.
Treatment Plan Suggestions:

Consultation: Schedule a consultation with a board-certified dermatologist or plastic surgeon experienced in treating dark circles and familiar with skin types similar to yours.
Combination Treatments: Depending on the underlying cause, a combination of treatments might be recommended. This could include fillers for volume loss and topical treatments or lasers specifically targeting pigmentation.
Skincare Regimen: Implementing a skincare routine with products that contain ingredients like vitamin C, retinoids, or peptides might also help improve skin tone and texture over time.
Follow-Up and Maintenance:

Regular follow-ups with your healthcare provider will be important to assess the effectiveness of the treatment and make any necessary adjustments.
I hope this information helps guide your decision-making process. It's important to have a detailed discussion with a specialist who can tailor a treatment plan to your specific needs. Best of luck in finding a solution that works for you!

Kyle Kimura, MD · Answer

Good question and thanks for the photo.
I would not recommend filler in your situation. There are many causes of these dark circles from poor sleep, increased fluid accumulation, allergies, etc. I would focus on some of these areas first as I worry that the filler may have a more negative impact than helpful.
Hope this helps and best of luck, Kyle Kimura, MD

Nelson Lee Novick, MD · Answer

I am not surprised by the lack of success with the lasers. The use of most of the expensive, supposedly "next big thing" light and energy-based devices are backed up far more by marketing hype and social media buzz than any hard science. 
 Dark under-eye circles are admittedly difficult to treat. However, gratifying results can be obtained with a combination approach that consists of the proper use of certain at-home, prescription topical skin lightening medications, coupled with a series of in-office superficial peels, such as high concentrations of salicylic or glycolic acid, Jessner's Solution or low concentrations of TCA. 
If necessary, an HA filler can be used to diminish the hollows, which can be mixed with a very small amount of light-colored filler, such as Radiesse, for its skin lightening effect. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Lexie Wang, MD · Answer

REMEMBER that filler fills. It does not change pigmentation issues. You are a candidate in the sense that there seemst o be some hollowing below the lower eyelid but I would not count on it doing anything for the darkness.

Leonard Grossman, MD · Answer

First and foremost, you have to understand that the dark circles you have are purely hereditary in signature and of ethnic quality. No lasers of any kind will help you. The only thing that will improve somewhat will be addition of your own fat to the lower eyelid to reduce the hollowness in the lower eyelid area. The pigmentation, however, will not change by any means. I hope this helps and good luck from Leonard Grossman, M.D. organic plastic surgery.

Camille Cash, MD · Answer

Fillers are an option for you to help improve contours and lessen shadowing that contributes to the dark under eye circles.  The filler treatment can be combined with topical treatments to help lessen the dark areas.  See an expert injector near you to learn more.

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