Best Treatment for Under Eye Hollows & Dark Circles? I have under eye hollows as well as dark purple circles within the hollows that have become more prominent every year. I've always had the under eye hollows, which progressively look more sunken. I'm tired of constantly looking tired. I've read about Restylane being a good option for this area, but is it the best treatment for my situation? What are my other options? If I received the Restylane filler treatment, would it help remove the dark circles too? Thank you for your question.
You submitted some very good photos and you're asking about treating the dark circles under your eyes and you describe very well its purplish. And it's very important to understand the basic cause of the dark circles and I know you've asked Restylane as a possible treatment. So what is it that makes your eyes look so purplish and so tired? Well, dark circles are typically caused by hereditary ethnic dark circles.
For example, a lot of people of Indian origin, Arab origin will have dark circles because of pigmentation genetics. Other things can cause dark circles actually opposite lack of pigment, the absence of pigment or the thinness or quality of skin where the skin is almost transparent and is only half a millimeter in thickness, very thin so you can literally see thought the skin and look at the blood vessels and the muscle that can create a bluish hue. Now many times, people who are very light-skinned have this issue. The things that can aggravate this issue I have seen includes smoking and sun exposure, anything that can cause the skin to be thinner can cause this dark circle appearance to progress further. Now although a filler can help fill in a hollow, it can't completely reduce the dark circles appearance completely but something that I have noticed about your photos that you didn't mention in your question is it appears to be some lower eyelid fat prolapse. Now what that means is not only do you have the dark circles but you have a bulge fat pockets in the inner aspect that's making the eyes look puffy.
Many of my patients over 20 years of doing this have complained of dark circles when they first came in and then when I pointed it out to them they also have fat pockets, we decided that a combination approach would make sense. Now what does that mean? Well, think of it this way: If your eyelid is very thin, the skin is accentuating everything by the translucency of it. Well, the fat pockets are pushing forward, it's like you're pushing that appearance of dark circles forward and when people look at you, we look at ourselves with great detail.
Whatever we see we tend to focus on and magnify that when people come to our practices like if they don't like the way bags under their eyes, they look, they notice that all the time. So there is a lot of reason why that's why a lot of people come to our office. They come because there is a dominant issue that concerns them that makes them want to seek attention. So when I help people with situations like yours, very often I'll do a combination where I would address the fat pockets. And if a younger person what appears to be may apply to you based on your photos, I would do something called transconjunctival blepharoplasty. Now what that means is I'll go inside the eyelids and address the fat pockets so they are not pushing forward and bulging.
Now that can help take away the accentuation of the dark circles. I also would routinely combine that with the use of platelet-rich plasma and sometimes with fractional Co2 laser. I'll help you understand that a little bit better.
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