Which procedure would best treat my under eye circles and hollowing? (photos)

Question

I have under eye hollows. I have researched a little and I may not be a good candidate for under eye fillers because my eyes hold water and get puffy regularly especially in the morning. I am Brown skin, 23 , male. I think the darkness under my eyes is mostly due to thin skin and veins visible from under the skin but there is also pigmentation. I also have little amount of bulging due to fat under my left eye. I already had 3 prf treatments without noticeable results. Which procedure?

Raffy Karamanoukian, MD, FACS · Answer

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 
Recommended Creams: Melarase Brightening Kit
MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Given your under-eye concerns, including hollows, puffiness, visible veins, and pigmentation, a multifaceted approach might be necessary to address these issues effectively. While under-eye fillers can be beneficial for filling hollows and improving overall volume, they may not always be ideal if you experience significant puffiness and fluid retention. In cases where puffiness and fluid retention are prevalent, fillers can sometimes exacerbate these issues or lead to uneven results. In your case, PICO laser treatments could be an excellent option to consider. PICO lasers are highly effective for targeting pigmentation and improving skin texture, which can help reduce the appearance of darkness and visible veins under the eyes. The PICO laser's ability to break down pigment and stimulate collagen production can improve skin quality and address the thinness of the skin, making it less prone to showing underlying veins. I hope this helps and best of luck!

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for your question and for providing a detailed description of your concerns. Given the complexity of under-eye issues, especially with a history of puffiness, it's important to approach this carefully.

Under-Eye Fillers: While fillers can be effective for hollowness, they may not be the best option for you due to the tendency for puffiness. However, a skilled injector might be able to use a very conservative amount to avoid exacerbating the puffiness.

Laser Treatments: Laser treatments such as fractional laser or intense pulsed light (IPL) can help with pigmentation and improve skin texture. These treatments can also stimulate collagen production, which might help with the thin skin issue.

Microneedling with PRP: Since PRF treatments alone haven't been effective for you, combining microneedling with platelet-rich plasma (PRP) might yield better results. This can improve skin texture and pigmentation over time.

Chemical Peels: Superficial chemical peels can help with pigmentation issues. However, they should be used cautiously on darker skin to avoid hyperpigmentation.

Surgical Options: If the bulging fat under your left eye is significant, a lower eyelid blepharoplasty might be considered. This surgical procedure can remove or reposition the fat to create a smoother contour.

Topical Treatments: Topical treatments with ingredients like retinoids, vitamin C, and peptides can help improve skin quality and pigmentation over time.

Given your age and skin type, a combination approach might be most effective. I recommend consulting with a board-certified dermatologist or plastic surgeon who can evaluate you in person and tailor a treatment plan specifically for your needs.

Manuel Diaz, MD · Answer

Hello! One of the best treatments for dark circles is under eye fillers. You should visit a specialist who will give you an effective treatment. That should work, improving the problem almost 100%. Good luck

Kenneth Brito, MD · Answer

Dear Chah27,
Appearance of under eye hollowness can be due to at least 2 reasons: hyperpigmentation or under eye fat bulging. If it is hyperpigmentation, then we use skin brightening products such as Vit C, Kojic acid, tranexamic acid, azeleic acid, tretinoin or combination therapies to treat the skin pigmentation. You can also use exosomes to the affected area. If the problem lies on the bulging fat, then the best treatment will be lower blepharoplasty. I suggest starting with a good skin regimen first.
Sincerely yours,Drkenbrito

Which procedure would best treat my under eye circles and hollowing? (photos)

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