Focus on Dark Under Eye Circles

A question I am asked frequently by patients is what we can do to correct or soften the under eye area.  It’s that dark shadowing under the eyes that often makes us look more tired than we actually are. This can be a trouble spot for all ages and both men and women alike.  I have treated patients in their 20’s, whose under eye circles prominent purely due to genetics.  I have also treated patients in their 80’s who are dealing more with changes from aging.  My response of course depends on the patient, but I will generalize here for a broad understanding.  Correction of the under eyes can be simply broken down into two categories of opportunity for improvement: volume and texture.  

Volume Loss

Lack of volume under the eyes can be hereditary as briefly mentioned above, but is more often due to the normal aging process.  As we age, we lose collagen and the fat pads underneath the skin shrink in size.   The results are deep hollows and features that appear deflated.  This aging process is inevitable.  However, with dermal fillers we are often able to replace the volume and “slow” the progression of this inevitable process.   Volume loss is where dermal fillers shine.  They are almost like a gel that is placed underneath the skin to help replace volume where it has been lost.

Texture

I use the word texture loosely here to describe other skin changes that are not related to volume.  Below are a few examples of issues in which filler will NOT help with.

  1. Loose or elastic skin under the eye happens from aging and environmental factors and cannot be corrected with filler.  And in some instances if the skin is overly “stretchy” in this area, placing fillers here can even make the problem more noticeable.  There are corrections for this including skin tightening procedures such as a blepharoplasty or CO2 laser.  However, non-surgical options tend to leave the patient dissatisfied with overall results. 
  2. Puffiness.  If you wake up in the morning and your eyes appear puffy and gradually improve throughout the day, edema (swelling) is coming into play here and will not be improved with filler.  If your eyes get super puffy from environmental allergies and create bags under the eyes—placing filler here will not correct this problem.  They will still get puffy!
  3. If your extremely fair like me, you have probably noticed some veins around your eyes.  These blood vessels are present in everyone but most prominent in lighter skin types.  This does contribute to the darkness we notice under the eyes.  However, this is not changed with filler.  Darkness from vessels can sometimes be treated with laser therapy-but fillers will not help with this.  So oftentimes I am telling my filler patients that even post filler, they may need some concealer to help with this. 

While this area is one of the more difficult areas to treat, it is one of my favorites! The results can be dramatic and natural all at the same time.  However, cosmetic procedures are never without risk and it is always important to be comfortable with your injector.  Knowing the anatomy and where the filler is being placed is CRUCIAL to safe and great results.  Most patients often need a combination of treatments to achieve their goals.  So pop into my office for a consult and we can work on a treatment plan together!