Restylane Vs. Arcus Marginalis and Fat Grafting for Dark Circles

Hi there, I'm a male of 27 years old . Having difficulties with reducing dark circles. I wanted to find out if restylane would work for me as the country where i stay cannot perferms this type of surgery. Please advise how would you recommend a surgeon inject the restylane.

Doctor Answers 6

Restylane works under the eye in selected patients

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Dark circles under the eye can produce a look of being "tired". These dark circles can be multifactorial and include engorgement of veins, dark melanin pigment, shadows produced by  overlying bags and lack of projection of the underlying bone.

Restylane injections in this "tear trough" can be very successful in selected patients, but is also fraught with risks and potential complications. 

It is always advised that patients who feel they may benefit from under eye injections, seek out a very experienced and certified aesthetic plastic surgeon or dermatologist who is skilled in the art of injecting this region.

Dark circles under the eyes

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If you have had these dark circles since early childhood, then you may have familial perioral hyperpigmentation that may not improve with even laser and probably not fillers. If you tend to get puffy under the eyes (it's hard to tell from the photograph) then the filler may make it more puffy as the most commonly used fillers here would be Restylane or Juvederm and both can absorb water and swell a lot.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Dark circles under the eyes -causes and treatments

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Dark circles under the eyes can be due to

1)thinning of the skin with increasing visibility of the underlying
2)shadows created by lax tissues or deep set eyes
3)generalized increased pigmentation seen in dark complexioned people
of Mediterranean or Middle Eastern descent
4)localized small blotches of increased skin pigmentation - age spots
- due to chronic sun exposure & aging
5)allergies like hayfever in which swelling closes off the veins from the lower eyelids so they get puffy and darker in color

1 is best treated with camouflage creams & sometimes surgery. 2 can be improved with surgery and maybe filler injections. 3 can not be changed. 4 may be amenable to CO2 or Yag or Ruby or Alexandrite laser. 5 is treated with allergy medications

I suspect you have 3

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Restylane and Juvederm are great for under eyes.

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Restylane or Juvederm work very well in the tear trough. Particularly in young people.

It is a tricky area requiring skill, however. The filler has to be injected in tiny amounts and deeply under the muscle, not under the skin.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Skin care for dark circles under the eyes

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In looking at your picture, it does look like adding something under the eyes would help to some extent in helping the darkness under the eyes. If you are leaving the country, remember that Juvederm is temporary so you should be aware that it will go away within the year. Fat augmentation will likely give you a longer lasting result.

For the dark circles you should also consider treating with skin care to see if it helps. Products like hydroquinone at a small percentage used sparingly can sometimes help, and as an alternative you may consider a new product called Metamorphosis from JolieMD which is used to clear excess darkness on the whole face but is gentle enough to use around the eyes as well.

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Restylane best way to go

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For your circles, filling is the way to go. You have only a small amount of lower eyelid fat and arcus marginalis release surgery will be a big disappointment. Not every doctor who does filler is qualified to do the service you need. You need approximately 2.5 ml of filler on each side. The under eye area needs Restylane but the top of the cheek can be treated with Perlane. So your home work and avoid surgery.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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.