Treating Visible Undereye Capillaries After Juvederm Injection

I've had dark undereye circles since I was young. Six months ago, I had Juvederm injected for these dark circles because the doctor told me it would fill in the grooves under my eyes, blocking the dark color and preventing it from being visible.

However, the opposite happened, and the dark circles/bruising became extremely worse. It also gave me slight undereye bags. Based on the research I did, my problem seems to be excessive vascularization, and I'll need a laser treatment for this. Who is the best doctor (best type of doctor) to see for this, and what is the best type of laser for removing the broken capillaries and veins?

Doctor Answers 4

Dark undereye circles typically not caused by broken capillaries

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Under eye darkness is primarily caused by 3 things: thin skin which allows the underlying muscle to show through, a shadow caused by hollowness under the eye, and pigment in the skin.

Injecting Juvederm (or any filler) under the eye will only help if your problem is caused by hollowness. If the hyaluronic acid filler (Juvederm or Restylane) is injected too superficially, it may cause a bluish tinge to show through which can look like a bruise. Furthermore, too much or incorrectly placed filler can cause fluid to absorb, making the bags worse. All of this can be corrected by injecting the filler with an enzyme that will dissolve it.

If, on the other hand, your dark undereye circles are from thin skin, then treatments to thicken the skin are preferable (such as retin a, peels, or laser resurfacing).If your darkness is caused by pigment, then skin bleaching or lightening creams (particularly ones with prescription strength hydroquinon) are preferable. You may have a combination of factors, too, confusing the issue. But for the most part, dark undereye circles are not caused by broken capillaries and veins.

Beverly Hills Oculoplastic Surgeon

Lower eyelid dark circles

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Dark circles under the eyes are very difficult to treat especially if it is not shadowing that improved with fillers.  Sometimes skin bleaching creams may help and sometimes lasers can, but usually it is vascular in nature and does not improve.

Visible blood vessels under the eyes after Juvederm injection

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Juvederm is an excellent dermal filler that is quite versatile for use throughout the face. Of all the areas can be used, the area under the eye is trickiest. This is because this skin is the thinnest in the body and has a very high concentration of blood vessels. If you continue to have visible blood vessels after he Juvederm injection visit with the dermatologist that performed us. They may recommend to wait for the resolution of this condition or may decide to inject the area with a small amount of hyaluronidase. Be sure that your dermatologist has great deal of experience with this as this enzyme is very powerful and can melt not only the Juvederm but your own tissues as well if not used properly .

Options for dark undereye circles

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Hi AJC.,

We specialize in both injection procedures for the undereye area and laser procedures. We use injections almost exclusively and think that your bad experience with the undereye injections was because your practitioner's technique was flawed, not because injections don't work.

The problem with trying to use lasers for dark circles under the eyes is not that you have too many veins, it's that the skin is very thin in this area. In most cases, the blood vessels that we treat with lasers are abnormal in that the actual veins (not just a brownish coloration like dark circles) are visible at the surface of the skin. When the blood vessels are not visible at the surface of the skin, like in your case, using lasers to treat the condition does not work well.

We strongly suggest you find an injection practitioner that is more experienced injecting the under eye area with Restylane or Juvederm. When done correctly it will solve your problem without the bruising and bags. To accomplish this, it must be injected deeper in the tissue or "under the muscle". Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.