Do I have to resort to surgery for dark bags with hollows? If so, what procedure? (Photo)

I have experimented with a wide variety of products and I have yet to see results. I would like to know if there is a product hidden in all the marketing that I am missing or if surgery would be my solution. I am a a bit tanned at the moment but the bags get quite bad when my skin gets lighter.

Doctor Answers 6

Treating Under Eye Hollows

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Since you have a very nice short lower eyelid, the best treatment is a filler of the hollow. Perhaps the reason you have not found the right "product" is that you have seen the wrong physician. Products like Restylane, Juvederm Ultra, Perlane, etc. do not work well in this area or cause problems. You need to see and expert injector in treating this area. I use only fat, Juvederm Voluma or Radiesse to fill the deep area, not the dermis or superficial area. When done properly, you can get execelent results. (See and

Highlands Plastic Surgeon

Dark Circles, Eyelid Wrinkles/Bags -- Restylane or Belotero, Laser C02/Erbium Resurfacing, Microneedling, Viva/Intensif, Fraxel

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You can treat under the eyes without surgery. In treating under eyes, a combination approach is best. I use a combination of lasers, microneedling/PRP, fillers and skin care/peels which can improve this area. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Lower eyelids

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You may be a candidate for dermal filler in the lower eyelids. Sometimes when patients experience a hollowness under the eyes it is considered a tear-trough deformity.  Fillers, like Juvederm and Restylane, do a great job of treating tear-trough deformities.  A tear-trough deformity can be effectively treated with fillers and sometimes this correction may help to off-set the appearance of dark lower eyelids.  However, the filler is not designed to treat under eye darkness and at this time there is no targeted treatment that will correct or eliminate dark lower eyelids.

Undergoing any cosmetic procedure requires careful attention to detail and consideration for different options.  Consider obtaining several opinions before moving forward with any given procedure.

Trust your face to a board-certified facial plastic surgeon or a board-certified plastic surgeon with very extensive dermal filler and blepharoplasty experience.

William Numa, MD, FACS
Boston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Dark hollows under eyes

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As you've found out, there is no magic potion or lotion that fixes this area for most women, and in fact, people waste a ton of money on them before finally seeking consultation, which is unfortunate.  The creams, especially over the counter ones, don't do anything to thicken the dermis, and they certainly can't create or fix an anatomic issue leading to a shadow, which is what you have.  So, what you need is either a lower lid blepharoplasty, or you could try some HA fillers in the tear troughs to try and thicken them up.

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 39 reviews


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There are injectable fillers that can certainly be used safely to fill in the hollowed out areas under the eyes. Great care must be taken to inject them in the right depth as if it is too superficial then the area can look uneven. Also there are multiple options for fillers including longer lasting options such as fat transfers. Be sure to see a doctor who has lots of experience injecting into this area specifically as it tends to be the most delicate area on the face to inject. 

Ravi Dahiya, MD
Washington Facial Plastic Surgeon
4.7 out of 5 stars 61 reviews

The Right Filler

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Based on your pictures, surgery is not necessary. You would likely see some correction from a filler such as Belotero or Restylane Silk to bring up the depths of the trough and improve the contour in the area. Thin fillers, such as these, have properties that allow the material to diffuse into the tissues more easily then other fillers — helping the material to spread out. When Belotero or Restylane Silk is injected correctly there is no visible or palpable bulge and no discoloration.

See the link below for more information on fillers.

A detailed examination will help delineate the best option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

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.