Are my Under Eye Circles and Hollows Related to Sinuses/deviated Septum? Could Restylane Help? (photo)

Thanks for the questions and including photos. Nasal obstruction from deviation of your nasal septum is not related  to your eyelid contours. From your photos you appear to have a slight amount of orbital fat pushing your lower lids forward and creating a bulge. This can be removed with a lower lid blepharoplsty procedure. Alternatively the bags can be camouflaged temporarily with injection of fillers around the area such as Restylane.  

There is some relationship between the under eye area and the sinuses but it is usually more of a fluid-type of relationship. Whenever the sinuses get congested or there’s an allergy, there is a common pathway where everything drains and it is located behind the eye. Very often that area can have some fluid. Now in your case, that’s not what we’re talking about. With you, it’s more about the thickness of the tissue and the volume in that area.

 

The area from the eyelid to the cheek, which we refer to as the eyelid-cheek junction or a transition point of the tear  trough area, is an area with some variability.  A lot of people are just genetically very thin in this area. We end up seeing it is a relatively bluish color because we’re basically looking through skin that’s almost transparent, and the color is from the blood vessels.

We look at this area in a couple of different ways. One, we look at the cheek area and see if any volume may be added to the cheek. When you’re young, we’re not interested in having you do a lot of procedures that are typically more age-related procedures. However, conservative options may be something worth entertaining.

 In our practice, we do procedures such as the use of platelet rich-plasma or platelet rich fibrin matrix to help add some collagen and improve skin quality. This is a leading edge procedure where platelets from your own blood and is spun down for a pure platelet concentration which has growth factors. These growth factors work very well in improving the skin quality and building the collagen under the skin. In addition to this, we also routinely use hyaluronic acids such as Restylane to add some volume and to help soften the tear trough area.

 

As far as answering the question about the sinuses, you may manage your sinuses and deviated septum but I wouldn’t expect too much of a dramatic change in the skin quality under the eyes. It should be potentially addressed with a variety of approaches using natural methods as well as with injectable filler. I hope that was helpful, and thanks again for your question.

The two best options for your undereye complaints are dermal filler (Juvederm, Restylane) injections or lower blepharoplasty. Filler treatments are an in office procedure with minimal to no downtime with results that last about 9-12 months. Lower blepharoplasty provides a permanent improvement. Surgery takes about 45 minutes and has one week of downtime. I hope this information is helpful.Stephen Weber MD, FACS