Getting rid of deep set eyes, lines and dark circles? (Photo)

I'm 30f from india. All my life I've had deep set, tired looking eyes. Now with age they are looking worse. The skin around my eyes is very thin, so much so there are red spots which are actually capillaries I can see. I'm desperately will help make looking for answers. Thank you

Doctor Answers 5

How to Treat eep Dark Circles Under the Eyes

Thanks for including your photos. It appears that you have a tear trough under each eye. While there are many approaches to dealing with this, a filler would be the easiest, least invasive way and give you a very nice result. There are a number of fillers to choose from, but the long term filler, Bellafill out shines the others as long it is injected judiciously and with a cannula.

I have added a web link to pictures of women who have had Bellafill under the eyes for a similar problem as well as a video to help you understand a little about fillers.

I hope that helps.

Best regards.


Kirkland Plastic Surgeon
4.9 out of 5 stars 58 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.  All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.

Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Getting rid of deep set eyes, lines and dark circles?

There are numerous reasons for dark circles including: Lack of fat in the hollow area called the tear trough, small blood vessels under the skin, congenital pigment in the skin, and shadowing from a combination of hills (fat pads) and depressions (tear troughs). Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: Botox or Dysport, temporary hyaluronic acid fillers like Restylane, long-lasting micro-fat grafts, light peels, lasers, blepharoplasties, or combinations of procedures. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

A temporary filler like Restylane would be a reasonable initial treatment. It can improve the cosmetic appearance of the eyes. The dark circles will be less obvious, but not totally eliminated.

Following the advice of anyone who would presume to tell you what to do without seeing 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

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Deep Set Eyes -- Restylane!!

Hi Koko.  You are a picture perfect candidate for Restylane injections under the eyes.  Because the skin is very elastic, the product holds very well and works to camouflage the color problems and at the same time replace volume that is apparent because of your genetics.  

To see examples of many before and after pictures of Restylane injections under the eyes to treat dark circles and tired eyes, click on the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Tear trough deformity and eyelid fat prolapse.

The photo is helpful, but an in-person evaluation is more valuable. In general, there are three reasons why the skin around the eyes can be [or seem] darker:
1. The thin eyelid skin allows the darker muscle underneath to show
2. The contrast between eyelid fat bulging, and hollowness at the orbital rim [tear trough] eyes can create a shadow effect that exacerbates darkness.
3. Skin pigmentation [sometimes from blood products from bruising] If it is bloodproduct pigmentation, it could last months to improve.
Depending on which of the above is the issue, different modalities may be helpful [time, fillers, laser resurfacing, concealer etc].

In the first picture, it seenms that you have prolapsed lower eyelid fat and a tear trough deformity [hollowness between eyelids and cheek]. There are a couple of different ways to address this:
1. Transconjunctival blepharoplasty [surgery] to excise or reposition your eyelid fat.2. Injectible fillers [Restylane or Juvederm] to fill in the hollow between the eyelid and cheek.
Both are effective. The surgery is a more permanent solution but is more expensive. The fillers are temporary [last 6-12 months on average] and is less expensive, but need repeat injections every year.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 33 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.