Thank you for your question. I understand you’re concerned about the appearance of your eyes, and say you’ve had dark circles under your eyes ever since you were born. You also underwent lacrimal gland removal surgery on your right eye nine years ago. Currently, you’re asking if you can improve your dark circles with surgery, and you’re also wondering if you can have Lasik surgery despite your right eye being unable to produce tears as effectively due to the removal of the lacrimal gland.I can give you some guidance on this matter. I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculoplastic and oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years. Oculoplastic surgery is a specialty where training is first in eye surgery, then in advanced cosmetic and reconstructive surgery of the eyes and face.Looking at your photos, there are no clear profile shots, so I have to ask if there is puffiness under your eyes along with the dark circles. When it comes to treating eyes, we first look at the skin quality, texture, genetic factors, sinus issues, allergies, and also which elements of the dark circles are due to external factors such as sun exposure, wind exposure, and other environmental factors. Puffiness usually manifests in the form of bags under the eyes, and depending on the severity, there are a number of solutions for them.Slight under eye puffiness is easily treated with the combination of platelet-rich plasma and hyaluronic acid fillers like Juvederm or Restylane. Platelet-rich plasma is a concentration that is derived from your own blood. It helps stimulate improved blood supply and production of collagen, and improves lower eyelid skin quality. This non-surgical method is usually used to fill in the tear trough area and has proven to be very effective.When it comes to dark circles, if there is an issue with skin texture and if you are the right skin type (which refers to skin that does not tan easily), then you can opt to have laser or fractional CO2 laser treatment to rejuvenate the area. It is important, when treating dark circles, that the patient fully understands that extent of what can and cannot be done, because with things like genetic ethnic pigmentation there is always a limit. I don’t advise skin bleaching for dark circles because it doesn’t work well, and usually leads to the skin feeling sensitive, inflamed and irritated. In my opinion, I feel that bleaching agents are better used conservatively for reactive hyperpigmentation.However, out of all the treatment options that are available, one that works consistently well with dark circles is platelet-rich plasma, regardless of the cause. This is because in addition to the benefit of collagen and blood supply stimulation, the thickness of the skin itself is also improved, thus improving the discoloration as well. Overall, the results can be quite significant.With regard to your question about surgery for dark circles, I would not recommend this for you because surgically, it is very difficult to attain the kind of results you want. You may get short-term benefit from it, but more often than not, it can result in scars on the sides and in some cases, the skin will widen and stretch and end up back to where it was.In terms of your lacrimal gland issues, it is important to understand that you will need lubrication on the eyes for a successful outcome for Lasik surgery or any other cosmetic eyelid procedure. A regimen for properly lubricating the eyes is recommended. In some cases, only after Lasik was done they realize how significant their eye bags or eyelid hooding are, so it’s smart you are proactive and carefully thinking this through.You should meet with an ophthalmologist and discuss therapy options for managing your dry eyes, and how to compensate for the loss of a lacrimal gland. I recommend you also meet with experienced and qualified cosmetic surgeons who specialize or perform a lot of dark under eye circle treatments. It’s not an easy thing to treat, especially since every approach must be customized for each individual.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
