Permanent Fix for Dark and Deep Tear Trough?

I have had my tear troughs filled with Juvederm for the past two years now, and even prior with Captique. I've been happy with this fix as it's the best I've found yet to improve my dark under eye circles.

While they remain red from the under lying blood vessels & muscle, filling them they do look much improved. I would really like to find a permanent solution to this. [I have makeup on in this photo but it's been 9 months since my last injection.]

Doctor Answers 3

Permanent Fix for Deep, Dark Tear Trough

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Hi Dark Circs,

Fat transfer is the best "permanent" fix for the hollows under your eyes. As you know, this is a very delicate and unforgiving area. Needless to say, you must have an experienced and well trained specialist treat you, and even then there is the possiblility of complications.

Restylane injections in this area seem to last over one year, and even after the product has worn off, it seems that the hollow does not return as deeply. With repeated treatments, the effect lasts longer (Restylane has been shown to stimulate collagen production).

Good luck and be well. Go see "The Picture of Dorian Gray".

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Fillers are best option for deep tear troughs

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While many patients seek a "longer lasting" answer, I would caution you that if you are happy with the results from the filler, it is best to stay with this option.

Permanent fix for dark circles

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I cant tell from your photo if you have fat bulges above the tear troughs. If you do then blepharoplasty to remove the extra fat will certainly help.

To reduce the darkness, a chemical peel will help. You can also have laser done, such as Erbium to improve the color and thickness of the skin.

Your eyes look good at this time. If you get desparate trying to get a permanent fix you might end up doing too much. That increases the risk of complications.

Take your time with a step wise approach;

a. Regular skin care, especially a toner. I love Nutrient toner from PCA (Physicians Choice of Arizona) skin care line.

b. Strict sun protection, use sunscreen and dark sunglasses every day.

c. Mild chemical peel like 25% TCA in winter time

d. May be a longer lasting filler like Sculptra (But only by someone who does a lot of Sculptra and has done it around eyes.)


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

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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.