Restylane for Dark Circles? What Are My Options Before Doing a Fat Graft? (photo)

I always had dark circles. In the past few years, they got worse. I am so tired of trying to hide using makeup. After some research, I think that besides my genetic predisposition, the hollow under my eyes are worse than it used to be. Do you think that using a filler I would see some improvement? (I am realistic and am not expecting to get completely rid of it). I don't want to do fat graft before trying a temporary filler. Also, any tips on helping me find a good doctor in my area? Thanks!

Doctor Answers 7

Restylane and under eye treatment

Yes, I think you would benefit from treatment to your tear troughs with a dermal filler, such as Restylane or Juvederm. It would be most beneficial to see you in person and assess your specific needs to discuss the best options.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Lasers and injectables for dark circles

A component making your dark circles worse is underlying volume loss, which is contributing to the hallowness you can appreciate.  Hyaluronic acid fillers can be used to restore this volume nicely in the hands of a qualified practitioner.  Fillers won't address the entire problem. Lasers may be used to stimulate both collagen production and reduce some pigment of the skin under your eye, which are also factors that can contribute to what appears as a 'dark circle.'

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 84 reviews

Restylane for dark circles

Much of your dark circles are from the shadow under your brow and eye ball. You are correct in that it is heritary. Anatomically, you have a deficient infraorbital bone (the bony rim under your eye). If you look up into a light while looking in a hand mirror, most, if not all, of the circles will be gone. Light comes from over-head in most instances, creating the shadow. Most people have the shadows below the bags under their eyes. Yours are a little different because the origin is the mentioned infraorbital bone.

The solution is to simulate bringing the bone forward. This can be done with Restylane or fat grafts. You have a great idea to try it first with something temporary, and for that particular area I like Restylane best. It leaves a smooth result and is reversable with an enzyme if necessary. It will take a minimal of one syringe (1 ml) for each eye to start with--probably more if you like the effect.

Fat grafts (transfer) will help also, but must be done by someone with much experience. Lumps in this area from fat injections usually must be surgically removed.

Another alternative is a silicone implant. I have done many of these and every patient has been elated. Even then, however, touch up may be necessary with either fat or Restylane. But, it is a permanent solution.

I recently had a patient who told me that the implant that I inserted years ago changed her life.

Good luck. I'm sure you will be very happy when you do any of the above solutions.

E. Ronald Finger, MD
Savannah Plastic Surgeon
4.8 out of 5 stars 78 reviews

Restylane is a good idea.

Thank you for submitting photos. There are several things that one can see...your skin is darker above and below the eyes..that suggests an inherited component, as you stated. It also appears to me that you may have some sun damage under your eyes. While looking in the mirror, gently pull the skin down from below your eyes and I think you'll notice some freckling involved..your doctor should start you on a gentle retinol cream to help reverse the sun damage, and that will help brighten your under eye area. Of course, wear sunscreen daily, or wear sunglasses to protect the skin. I do think that injection of Restylane would look nice. If for some reason you do not like the outcome, your physician can inject hyaluronidase and dissolve the Restylane. I agree with the other physician respondents..make sure you are with an experienced injector.

Christine Glavey, MD (retired)
Alpharetta Dermatologic Surgeon
4.4 out of 5 stars 14 reviews

Restylane for under eye circles or hollows

The under eye circles can be improved nicely with Restylane, a hyaluronic acid filler.  It is important that the physician that performs the procedure is a board certified dermatologist or plastic surgeon with training and experience in performing this procedure. This area has to be approached with care, as filling this area may result in a number of potential complications.

All that said, most patients do well with this procedure.

I find that this area needs to be slightly under-filled, at least on the first treatment, which helps decrease the risk of persistent edema under the eyes.

Additionally, there appears to be some hyperpigmentation in your photo, that is not strictly due to the hollows themselves.  You may need to use a fading cream after the filler treatment.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Fillers for under eye circles

You may get some nice improvement with under eye filler.  It is best of course to see you in person where we can palpate the area and approximate what we can achieve with filler.   Finding an experienced doctor is of paramount importance as this area can be tricky and optimal results require a lot of experience.  Go to the web sites for Merz, Allergan, and Medicis and find a doctor who trains for at least two of the companies that make hyaluronic acid fillers. Best  to you.

Jacqueline Calkin, MD
Sacramento Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Restylane works for dark circles

Yes, Restylane is a great option to improve dark, under-eye circles, prior to considering a fat graft. A conservative amount, 1 syringe or less, would give you a contour correction that appears natural.

Good luck!

Daniel Levy, MD
Bellevue Dermatologic Surgeon
4.9 out of 5 stars 42 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.