Dark under eyes

Question

Hello, I have been battling dark under eyes for as long as i can remember. I have tried creams/serums, filler, microneedling, light therapy and nothing has worked. I read that a bleph with fat transfer is the way to go but also that the right placement of filler could also work, however, I’m looking for a permanent fix. Looking at my under eyes, what would be recommended

Waylon Zeng, MD · Answer

Hi thank you so much for your question and sharing your photos! I can definitely appreciate your concern of the dark circles in the under eyes. This is a relatively common condition. My recommendation for dark circles is typically to inject nanofat into the skin of the under eyes. This is not the same a regular fat transfer. The fat that is harvest is filtered down so that only the stem cells remain. These living stem cells are injected into the skin which will renew the area and help with the dark circles. It reduces the pigmentation and brightens the lower eyelid. This is a better fix than PRP/PRF in my opinion, which is dependent on the quality of your plasma when it is drawn up.

Yily De Los Santos, MD · Answer

Dark under eyes don’t have a single cause, which is why many treatments fail when the underlying issue isn’t properly identified. They can be due to pigmentation, hollowing, volume loss, or even bone structure.

If you’ve already tried creams, fillers, and other treatments without improvement, it often suggests the issue is more structural rather than superficial.

When hollowing or volume loss is the main concern, filler can help, but it’s not always the best long-term solution, especially if you haven’t seen results from it before.

Surgical options like lower blepharoplasty with fat repositioning or fat transfer can provide more lasting results because they address the root cause rather than just masking it. However, it’s not the right solution for every case.

It’s also important to understand that “permanent” doesn’t always mean perfect in every aspect. If pigmentation is part of the issue, surgery alone won’t completely eliminate it and may require additional treatments.

The key is a precise diagnosis to determine what’s actually causing your under eyes. From there, the right treatment plan can be tailored to achieve a more effective and lasting result.

Dark under eyes

Answers (2)

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