Solutions for my severe dark circles/tear troughs? (Photo)

Question

I've had severe hereditary dark circles for my entire life and they are only getting worse with age. I'm a 32 year old male. What procedures or treatments would you recommend to reduce this problem? I would prefer something nonsurgical or at least minimally invasive. I've thought about filler but I'm freaked out by the rare occurrences of blindness. Also seems like filler doesn't last long and can migrate to unwanted areas. That being said, I haven't completely ruled it out. Thank you.

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Fillers have been used for the under eye tear troughs and hollows since the the early days with the original Zyderm collagen fillers. In the past dozen or more years, natural hyaluronic acid fillers have been used to improve tear troughs, hollows and even dark circles. Since the cheek region immediately below the infraorbital area is a major anatomical support for this area, sophisticated and experienced injectors typically treat the upper cheek region with a robust filler, which often provides sufficient support to the area below such that no further treatment is needed. If additional treatment is required, then a much less reobust, cohesive filler may be used to further improve the result. You would be wise to consult with a board certified cosmetic dermatologist and be sure to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Leonard Grossman, MD · Answer

You’re absolutely correct in stating that this condition is hereditary. Even though the photograph is of limited scope, it appears that you have lower eyelid bags which need to be addressed by means of trans conjunctival blepharoplasty. It is the lower eyelid bags that cast a shadow over your cheek area making it look like a dark circle. It would be extremely helpful for you to be evaluated in person because normally individuals such as yourself also have lack of fat in the cheek area immediately below the lower eyelids. I hope this helps and good luck from New York City Plastic Surgery

Solutions for my severe dark circles/tear troughs? (Photo)

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Solutions for my severe dark circles/tear troughs? (Photo)

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