Dear Dr Seckel I am 33 y/o I have had dark circle under and around my eyes forever at times its worse than others, My eyes are sunken, or hollow look, skin around my eyes are thin and transparent, therefore the veins are more visible. The inner eye area by the nose seems to be the worst. What makes matters worse is the bone structure of my eyebrow it is prominent and casts a shadow which makes the darkness seem worse. Some causes are probably genetic, allergies and fatigue, I’ve read many do’s and don’ts for under eye circles and tried numerous expensive products, but you know how that goes. I have had my brows thinned out and had eyebrow tattoo to give more space, it helped. I also had fat injections, I am sorry I didn’t read your opinion about blepharoplasty and fat injections before I did that because it was not pleasant. The bruising and swelling lasted for months, I was told up to a weak. When I had the fat injections the MD suggested that I also put some in my cheeks and in the lines around my mouth and nose, Cheeks were nice but the fillers around my mouth make me look like I’m frowning all the time, its not very attractive. So now I don’t just get remarks like “are you OK”. “Are there problems at home” you look depressed, tired, sick and worst of all my children say “mommy you look so sad” but now I get that “You look mean and you’re scaring the patients away” constantly, every day. Even my own parents who have similar features dare to say the same. PLEASE help, Fatima , Staten Island, New York
Dear Fatima,
I am sorry to hear of your experience and your concerns about dark circles under the eyes. Please don’t give up; I am sure you can be helped.
From your description it seems that the dark circles under your eyes, - which I call the naso-jugal fold or “tear trough”- were the main problem that you sought help for. If the fat injections did not work there are other eyelid rejuvenation techniques which can help.
I have been pleased with the results achieved by a blepharoplasty technique which includes an arcus marginalis release and placing a fat graft on the bone beneath the dark circles under the eyes to plump the area up and eliminate the shadow.
What is unique about the operation, called a laser transconjunctival blepharoplasty with arcus marginalis release and fat grafting, is that I do the procedure through a small laser incision on the INSIDE of the lower eyelid-thus there is no scar on the outside of the eyelid.
More importantly, with no incision on the outside of the eyelid, there is no change to the shape of the eye and healing is much quicker. This avoids the ectropion or sad eyed look that can happen when a blepharoplasty incision is made on the outside of the eyelid.
The shadow created by your brow can possibly be reduced by contouring your brow, but this is a bigger operation and I would try the tear trough implant first.
Regarding the problem with the appearance of your mouth, I would have to see your pictures first to understand the problem.
If you want to email me photos I would be happy to evaluate them.
Good luck, and don’t give up.
For more information on eyelid rejuvenation blepharoplasty, dark cirlces under the eyes and non-surgical facial rejuvenation read Save Your Face or contact me.
Boston, Massachusetts