Will the dark circles under my eyes get darker after open rhinoplasty?

Question

I already have dark circles under my eyes, and my plastic surgeon has said that they might get worse (even darker) after my rhinoplasty. Is a closed approach less likely to worsen this problem? Are dark circles more prone to get darker if the rhinoplasty is open? This issue worries me a lot since i already have some serious dark circles under my eyes. Thank you!

Daniel E. Rousso, MD · Answer

Dark Circles under eyes after a rhinoplastyDark circles may be noticeable
after a rhinoplasty for a number of reasons.  The most common cause for
bruising after a rhinoplasty is
from pigment deposited into the skin after the bruising has subsided.
 Bruising after a rhinoplasty can be caused by many factors.  This
can depend on the patient's own tendency to be an easy bruiser, medications or
supplements the patient took preoperatively, the nature of the patient's bone
structure, the techniques that the surgeon uses during the surgery, the type of
anesthetic that is used, the duration of the surgery and the aftercare.
 Typically, patients that are easy bruisers, that have thicker bones that
require more aggressive surgery, that take a long time during surgery and don't
rest adequately after the procedure will have more bruising.  Regarding
the question as to whether you will have more bruising with the open or closed
approach, I do not believe that there is any significant difference between
these two techniques.  Bruising after a rhinoplasty is common but usually
goes away within a week or two.  As the bruising subsides, the pigment
from the degrading red blood cells can persist in the skin for many weeks in
some patients.  This usually subsides as the dead skin cells carrying this
pigment slough off over time.  Another common cause for the dark circles
after a rhinoplasty may be from the swelling of the mucous membranes in the nose
after the procedure. This can cause obstruction of the venous blood flow to the
lining of the nose and sinuses and my manifest as a purplish-blue color under
the eyes.  This is especially noticeable in patients that have an
underlying allergy problem that may be exacerbated by the rhinoplasty
procedure.  Treatment of the allergies with nasal steroids and
antihistamines can improve this problem.  Regardless of the cause of the
problem, prevention is usually the best medicine.  Choose a surgeon with a
great deal of experience doing rhinoplasties.  Ask your surgeon how many
rhinoplasties they perform in a year.  A surgeon who performs 100
rhinoplasties a year usually can achieve better results than a surgeon who
performs one or two.  Ask to see some before and after results.  Of
course, your nose has a unique set of characteristics, and you may not see an
example that matches your nose exactly, but you should at least be comfortable
with the doctor’s results.

William Portuese, MD · Answer

There are many reasons that cause dark circles under the eyes which include deeply  pigmented skin, bags, and allergies. The rhinoplasty procedure usually involves  osteotomies placed in the nasal bones which resulted in bruising into the lower cheek area. The bruising itself is temporary. On a few occasions some patients get something called hemosiderosis which is in iron pigment leftover in the red blood cells trapped underneath the skin that can give the appearance of worsening dark circles under the eyelids. This is self-limiting and usually goes away in approximately 6 months.  Hemosiderinosis can occur with either open or closed rhinoplasty.

Will the dark circles under my eyes get darker after open rhinoplasty?

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Will the dark circles under my eyes get darker after open rhinoplasty?

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