Restylane or Lower Blepharoplasty with Fat Transfer to Treat Under Eye Circles? (photo)

I am Asian and have been living with dark circles under my eyes since I can remember. I am in my Thirties and it's getting much worse as the years go by as now it's a combination of discoloration and loss of volume under the eyes. I understand this is on one of the trickiest areas to treat and have been getting mixed advice from doctors on treatment options. I would appreciate any feedback as to which option would provide the best results for my situation.

Doctor Answers 8

Restylane or Lower Blepharoplasty with Fat Transfer to Treat Under Eye Circles?

Most expert experienced artistic plastic surgeons have a variety of procedures at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers with hyaluronic acid fillers like Restylane which usually last 6 months to 1 year, micro-fat grafts of your own tissue - 30-50% lasts permanently, and blepharoplasties which are more than you would usually need at this age. There is no one best procedure that would be applicable for everyone. Each has benefits and potential drawbacks. The vast majority of board certified plastic surgeons with extensive experience in eyelid surgery and soft tissue fillers would warn against using a permanent synthetic filler because of the long term complications which can occur even years after injection and are difficult if not almost impossible to correct.

The best option in any particular patient needs to be individualized based on desired outcome and personal anatomy. The improvement of the contour is more reliable than improving the discoloration.

Following the advice of anyone who would presume to tell you exactly what to do based on limited 2 dimensional photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Restylane or Lower Blepharoplasty with Fat Transfer to Treat Under Eye Circles?

As you mentioned in your comment, this is one of the trickiest areas to treat because discoloration can be really a pigmentation in the skin.  It can be shadowing or it can be a combination of both and treatment should be targeting the real reason and options are several. Maybe it is a good idea to consult with a plastic surgeon that has experience with this type of problem.

S. Ozan Sozer, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 195 reviews

Restylane or Lower Blepharoplasty with Fat Transfer to Treat Under Eye Circles?

    I think that fat transfer to the tear troughs or Restylane to this area could be considered.





Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Dark circles and troughs

can be helped with fillers or fat grafting if you are willing to accept the risks of the procedures.  I'm much more confident with improving contours and less proficient with removing the darkness so make sure you know what your surgeon can and cannot do.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Under Eye Dark Circles in Asians can be treated

A significant number of people of Asian heritage notice dark circles under their eyes in their 30s. While dark circles can affect how you feel about yourself there are treatments that help you overcome this. Here is what I think can be done in this case.

Since the cause is loss of bony volume in the area under the eyes, replacing lost volume with a dermal filler such as Juvederm, Restylane or Esthelis helps. You should consult with a Plastic Surgeon with expertise in this area. I don’t think Surgery is necessary at this point in time. If you are happy with the results following fillers, you can consider a permanent implant or a permanent filler.

Do you think 30s is a reasonable age to start dermal fillers?

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 74 reviews

Dark Circles in the Under Eye Area

The treatment of the lower eyelids is complex and involves a lot of different factors.  These include the tightness or laxity of the skin; the presence of extra fat or thick muscles tissue; and the contour of the midface/cheek area.  In younger patients, fillers can be used to camouflage the contour differences in the lower eyelids.  This is sufficient in many cases. For some patients who have tried fillers and been disappointed, lower eyelid surgery may be an option. In my practice, I recommend transposition of the orbital fat to fill in the hollows. Please visit with a couple surgeons to get opinions in person before choosing the best procedure for you.

#eyelid surgery San Francisco

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 113 reviews

Restylane or Lower Blepharoplasty with Fat Transfer to Treat Under Eye Circles? (photo)

The best treatment for dark coloration of lower eyelids depends on whether the darkness is from fine skin wrinkles, a shadow beneath bulging lower lids, dark skin pigmentation, or a combination of these factors.  The photo doesn't give sufficient information for me to differentiate these contributing elements.  Consider in person consultation with plastic surgeons in your area.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 47 reviews

Treatment of dark circles under the I may require a combination.

You have some fat herniation that may create some shadowing. Also appears as though there hyperpigmentation in the skin of the lower lids. This might benefit from a two-pronged approach. I would start with a bleaching cream to see if it has any effect.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 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.