I am a 50 year old woman with her eye bags with a dark tinge. Concealer just makes it worse. What can I do? (Photo)

Answer:
From your picture, it appears you have lost some of the fat below your lower
eyelid, causing a tear trough to form. This is a normal part of the aging
process, but the lack of fat between the thin skin under your eyes and the
blood vessels below, creates a darkened appearance. The mounded “bag” below
your eye (the tissue mound which holds the eye in the socket), casts a shadow
on the darker area below, making it appear even darker. The most effective
solution is to replace the lost fat with a transfer of your own fat, usually
taken from the stomach or love handles, to replace the fat you’ve lost as you
age. This is a long-lasting non-surgical solution.

The
next-best option would be to use a dermal filler in this area. I personally
like Belotero for under the eyes, as it does not have the blueish coloring some
other fillers do, and creates a very soft, smooth appearance. Hyaluronic Acid
fillers, like Belotero, Juvederm, and Restylane last for varying amounts of
time, usually a few months to a year. Your body slowly metabolizes them, so
your tear troughs would slowly re-appear over time without retreatment.

There
is no truly non-invasive option which would replace the volume of fat you have
lost. However, both fat transfer and dermal fillers are minimally invasive, so
the downtime is fairly short.

I would probably recommend a touch of HA filler such as Restylane in the tear trough area to fill in the hallow and reduce the appearance of dark circles. Schedule a consultation with a board certified plastic surgeon in your area to discuss. My best,Dr. Sheila Nazarian@drsheilanazarian on Instagram

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

If you're interested in non-invasive options for lower lid "dark circles", then fillers and topical lightening creams would likely be the good choices.Fillers help in restoring volume to the hollowed area (which contributes to the "dark" appearance) and the lightening creams can help with residual pigmentation changes.Of course, these are merely general suggestions and you would need a thorough in-person consultation with a board-certified physician who has experience in treating these areas. Best of luck.

Dark circles are related to bony changes in the face over time
as well as volume loss due to fat loss in the fat compartments of the face.
There are also pigment changes that happen around the eyes over time. Often
times we find that lifting and supporting the cheeks with Radiesse can augment
the eyes and balance the features. We can further correct the delicate under
eye area by using thinner and softer hyaluronic acid fillers such as Restylane.  It is an off-label treatment and is best done by a trained oculoplastic surgon.  Fillers wear off gradually and if you don't mainain it will eventually go back to it's original state.
For skin changes, there are certain
products that will help lighten the skin such as hydroquinone and vitamin K.
Light chemical peels and light-based treatments such as Intense Pulse Light can
also be helpful for treating dark circles. Seek out a trained injector surgeon
who specializes in aesthetic medicine to find out all your options. Best of
luck.