What do about volume loss and dark shadows under eyes after weight loss? (photos)

Question

I had quite a bit of weight loss last year (at the age of 28) and since then, my face has looked awful. I look much older than my age because of the facial fat loss. I’m now underweight and trying to gain weight but I’m not sure it is going to help. At the same time i also have these dark circles that have appeared up underneath my eyes. It started off with one eye and a few months later, the other eye started looking the same. I can only see them when I’m a few ft away from the mirror.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Camille Cash, MD · Answer

Fillers are a wonderful tool for replacing lost volume and improving facial contours.  One of the nice benefits is that you can go slowly and build up to the look you are wanting.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day to keep skin looking healthy and balanced.

Bernard Tan, MBBS, MRCSB · Answer

Hi there!
Facial volume loss is commonly seen after rapid weight loss, unfortunately the facial fat in the face also loses volume together with fat elsewhere. This gives a sunken, tired and gaunt look on the face. 
Thankfully, this can be effectively and safely corrected with fillers. Choice of filler material includes hyaluronic acid such as Juvederm (most common, safe and reversible), collagen stimulators like Ellanse or Sculptra (long lasting, results take a few weeks to be seen) and fat grafting (need liposuction from elsewhere then inject into the face). 
Each choice has its pros and cons which should be discussed with your provider.

Todd Gaddis, MD · Answer

It's important to note that there are a multitude of reasons people develop the dark circles under eyes from aging, thinning skin, allergies, weight loss , sun exposure, genetics and more. Any Physician must take all of these into consideration on evaluation. Individual factors and combinations of these causes can vary, and the treatment or management of dark circles depends on identifying and addressing the underlying cause.
From the pictures I can see the volume loss. If that is the primary cause I like to address this area with a Hybrid Bio-Filler and PRF. Bio-Fillers are a gel product made exclusively from your own blood. You blood is drawn into a test-tube and centrifuged without any anti-clotting agents. This allows the fibrin clot to form which once extracted is called Platelet Rich Fibrin (PRF). PRF is much more dense in growth factors and and stem cells. This in turn is processed with heat into a gel similar in consistency to Juvederm, Restylane or other man made filler. Depending on the amount of volume loss and structural need I may choose another filler like a Juvederm product to combine with to give more lift. The Bio-Filler by itself can last 6 months, but in this time it stimulates vascular growth and your own natural collagen to grow. The Juvederm products all last over a year. I find this combo gives great long lasting results that look very natural.

Leonard Grossman, MD · Answer

Tear troughs that are either formed after weight loss, or are genetic in nature, are best treated by the patient having fat grafting. When fat grafting is done by an expert plastic surgeon, who specializes in fat grafting techniques, the results are natural and practically permanent. I hope this helps and good luck from New York City Plastic Surgery.

What do about volume loss and dark shadows under eyes after weight loss? (photos)

Answers (5)

Answer: Under eye dark circles.

Answer: Under eye dark circles.

Answer: The best way to treat tear troughs

Answer: The best way to treat tear troughs

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.

What do about volume loss and dark shadows under eyes after weight loss? (photos)

Answers (5)

Answer: Under eye dark circles.

Answer: Under eye dark circles.

Answer: The best way to treat tear troughs

Answer: The best way to treat tear troughs

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.