Filler did not work - what can I do to make this look better? (Photo)

Question

I have had dark circles on top and bottom eyelids since childhood. They keep getting worse and even makeup doesn’t cover anymore. I had filler injected, juvaderm i believe, but it did nothing for the darkness. What can I do to make this look better?

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You seem to be a very good candidate for nanofat injections in your eyelids. This is a very fine injection technique performed under local anesthesia that decreases pigmentation and evens out skin tone and volume is added as well. It is best to have a consultation virtually or in person to discuss options of course.

Vibha Gambhir, MD · Answer

Hello, and thank you for your inquiry! While under eye filler can address hollowness issues - PRP is a better treatment for the discoloration. PRP is platelet rich plasma. Your blood will be drawn and then the plasma is spun down and injected under the eyes. This is a collagen building procedure. This procedure will help thicken the skin therefor diminishing the discoloration. This procedure should be repeated about 3-4 times 4-6 weeks apart. There is some downtime associated with this procedure. You will be very swollen for at least a few days after and potentially up to two weeks. Good luck on your journey!

Filler did not work - what can I do to make this look better? (Photo)

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Filler did not work - what can I do to make this look better? (Photo)

Answers (3)

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.