Hello Doctor Seckel. I am 27 years old. I have had dark circles under my eyes for almost all of my life. I am tired of using concealer to attempt to cover them and have no success. I do not necessarily have bags under my eyes as in puffiness or extra skin. The skin under my eyes just seems to be very thin. I do have a hypothyroidism problem that I am treating with medication and am also taking birth control pills. What would you recommend for treatment? I have heard about fat injections, blepharoplasty, and laser treatment. I know I will need to consult a doctor in person; I’m just trying to decide what would be best? Please help….Nadine, South Korea
Dear Nadine,
The most common cause of dark circles under the eyes at your age is just that the purple color of the eyelid muscle is showing through your thin skin and making the dark purple eyelid color. Only a concealer such as Covermark® or Dermablend® can be used to help this type of dark circles under the eyes-no eyelid rejuvenation surgery is possible and fillers or fat injection will not help.
If you have brown pigment under your eyes from medication such as birth control pills the IPL (Intense Pulsed Light), photo facial or a very light laser skin peel might help pigment removal-but you need an expert-if laser peel is done too deep it could leave white skin which would look terrible especially on asian skin.
If there is a deep depression or hollow under the eyelid just on top of the bone of the eye socket then surgery would help. I do a procedure called transconjunctival laser blepharoplasty with arcus marginalis release and fat grafting to fill the hollow eye or dark circle under the eye and reduce the shadow, which makes the dark circle under the eye and hollow look worse.
This is a very sophisticated complex operation and must be done by a board certified plastic surgeon or oculoplastic surgeon who has much experience with eyelid surgery and the laser. Of course I need to examine you to advise you. Since you live so far away you could email me photos and I will give you my opinion. I need a close up of your whole face and a close up that includes your nose, eyes, and forehead. Also a side view of the eyes.
I do not do filler and fat injections around the eyes for eyelid rejuvenation -I think it is dangerous and there can be complications which are hard to correct.
For more information on dark circlesunder the eyes, hollow eyes and non-surgical facial rejuvenation read Save Your Face or contact me.
Boston, Massachusetts