I Have Dark, Large Under-eye Circles Which Are Getting Darker As I Age? (photo)

I am 37, and in pictures, I look very tired and older than I am. I do not want surgery, and don't know if that would even be an option. I see differing opinions on Fat Injections, Restylane, or other fillers? I would love some advice please.

Doctor Answers 9

Dark circles and Restylane

The photo you've posted is hard to see up close, however, you have many options for improving your lower eyelid region. Research a reputable and well-trained and informed injector in your area, read reviews, and consult with them for all of your options. Fillers, Botox, and skin care all help you feel and look rested and more refreshed, the youthful you.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Infraorbital Dark Circles, Tear Troughs & Hollows Respond Well To A Combination of Belotero Balance Plus Radiesse

Dark circles, tear troughs and hollows are some of the most common problems of the lower lids. Over the past several years, it has become standard practice to treat this region with lighter weight, hyaluronic acid fillers, like Restylane to lift, straighten, and contour this region. Occasionally, if fillers are inadvertently placed too superficially, a bluish discoloration related to light scattering (a phenomenon known as the Tyndall effect) can occur, which can actually make the dark circles more prominent. Belotero Balance, a relatively new hyaluronic acid product, has been manufactured to avoid this. However, I have found that the addition of a tiny amount of Radiesse, a whitish-colored filler, to the Belotero, to be an excellent way of treating tear troughs and hollows and lightening existing dark circles. The use of blunt-tipped cannulas introduced through the thicker skin of the cheek (rather than injections via needles directly into this thin-skin area) has made the treatment of the lower lids easier and faster and has reduced the risk of bruising. However, only a board certified aesthetic dermatology or plastic surgeon injector experienced in treating this delicate region should attempt to treat this area in this fashion.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Under eye circles

Dear sgriannon,

  1. Looking at your pictures, using Restylane under the eyes can improve your look, and the result may be limited
  2. If you want the best result, it looks like surgery with removing the fat and then doing fat injections to place fat in the correct place will give you the best, more longer lasting result
  3. When you are ready, see a plastic surgeon who can perform both surgical and non-surgical procedures to go over your options

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

I Have Dark, Large Under-eye Circles Which Are Getting Darker As I Age?

       A filler such as Restylane works well for the tear troughs, but significant bags would be better off treated with a surgical approach.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Dark circles under the eyes

It is difficult to give you specific advice based on the photo provided. In general, there are numerous causes for dark circles under the eyes, and an in-person assessment would be necessary to best advise you. Fat can cause the appearance of dark circles, which can be corrected by fat repositioning blepharoplasty.  As individuals age, skin tends to thin and the normal fat pads in the eyelids herniate from their normal positions and become more prominent.  This prominence can appear as bags under the eyes, and the shadow they cast appear as dark circles, while the thinner skin causes blood vessels to be more noticeable, contributing further to the dark hue.  Some pigment can be treated with laser and/or bleaching creams.  However, if it is too deep the treatment will not be effective.  Surgery can not correct dark circles due to every cause, but it will correct dark circles that are due to the aging process.  Depending on the needs of the patient, filler is a fantastic option. A filler such as Restylane is great for the tear trough. I would recommend a consult with a board certified specialist, as they will be able to evaluate your needs in person and provide you with advice. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Restylane works for volume loss under eyes

As the others have commented, your photo is hard to give specifics on but here is a general answer. As people age, many notice significant volume loss in the central face (under the eyes, cheeks). This can lead to shadowing and darkness. If what you have is volume loss there, adding fillers appropriately can add volume and decrease the shadowing effects. Seek consultations with a few board-certified physicians to determine what will be best for you.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Under Eye Procedures

Hi SG.  It's difficult to tell from the photos how much extra loose tissue you have under the eyes and this is one of the key factors in developing a plan for you.  

Restylane works great under the eyes and is an excellent way to avoid a surgical option.  It also typically lasts about 1 year.  

Our office is located in Torrance and Orange, CA and we do offer a free consultation.  See the links below for pictures.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Under eye hollowness

The photo provided is quite small and difficult to fully assess.  However, it appears as if you have loss of volume in the tear trough area.  Under lights, this will accumulate shadowing.  There are various options for this (both surgical and non-surgical) but I would strongly recommend an in-person consultation with a board certified specialist who can help you achieve the goals you desire.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Dark circles under eyes

Your photo is very small, so it's difficult to tell if you might be a candidate for treatment or not.  In general, if there are dark circles under the eyes, these can be caused from shadowing.  Sometimes this is due to protruding fat above the dark circles and sometimes it is just due to a depression under the eyes.  If there is protruding fat, then surgery is an option to improve the problem.  Another possible treatment option would be filling in the depression with a filler.  If a filler was used, I would recommend using Restylane, as I find it gives the best results in that area.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.