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!