What can I do to get rid of my sunken eyes and dark circles? (photos)

Question

What can I do to get rid of my sunken eyes and dark circles? I want to achieve a more awake appearance. I look tired and stressed. Please help.

David K. Isaacs, MD, FACS · Answer

Your photos are not clear so it’s not possible to say.

Generally speaking, if the lower eyelid are hollow, undereye filler, fat grafting, and/or silicone implants are options. I tend to avoid fat grafting in many patients (I’m the Course Director for our Academy’s Fat Grafting Course) because there can be a lot of issues with this treatment option. But the other options also have their own risks. Undereye filler is long-lasting but it’s also dissolvable, so you can at least see how it looks.

When the lower eyelid fat bags are visible, I perform a scarless transconjunctival lower eyelid blepharoplasty with fat repositioning. This is a great procedure to rejuvenate the eyes.

And sometimes I can even perform fillers when there are fat bags, and this is done to camouflage the bags. But this takes great skill and expertise.

See an Oculofacial plastic surgeon for a proper exam and recommendations.

Nima Shemirani, MD · Answer

Hi @lovelygirl001. You would be a great candidate for tear trough fillers. Restylane and Belotero work great. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.

Best of luck,

Dr. Nima

Best of luck,

Dr. Nima

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.

Sam Speron, MD, FACS · Answer

Thank you for your question and pictures!  Unfortunately, it is difficult to see your picture in these photos due to the blur.   Dark circles and sunken eyes can be corrected with blepharoplasty or cosmetic eyelid surgery. While the average age might be 30 to 50's, some patients get this done in their 20s. It is one of the first cosmetic surgeries people usually get.

Surgery is one option to consider. In today's day and age, there are also many nonsurgical options to consider. Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.

There are many options when it comes to reducing the tired and aged look of the eyes. It really depends on your unique anatomy as well as what exactly is bothering you. I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Marc Polacco, MD · Answer

Thank you for your question. There are a few ways to treat this, but it depends on the cause. If it's volume loss (the most common), filler in the tear troughs can help. If it's due to prominent blood vessels under the skin, sometimes light-based treatments work best. If you have puffiness due to allergies or congestion, then that would need to be addressed. Ultimately your physician should be able to make an evaluation and determine what modality will work best for you. I hope that helps!
-Dr. P

Zoran Potparic, MD · Answer

It is very difficult to visualize your real problem on these photos! In person consultation with a board certified plastic or oculoplastic surgeon is much better choice. However, from what one can see it is very likely that transconjunctival lower blepharoplasty, cheek augmentation with fillers or implants, would be some of solutions. Good luck.

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