“Although I am a fit, healthy and active person, everyone tells me how tired I look. I have noticed that BAGS AND DARK CIRCLES UNDER my eyes do not go away no matter how much sleep I get. Help!” –Janice, Los Angeles, California
Dear Janice,
What most people refer to as “bags “ and dark circles under the eyes are actually caused by fat pushing out against the lower eyelid skin. This tends to become more noticeable as we age and as the supporting tissues of the eyelid skin and muscle becomes more lax due to aging changes. The amount of “puffiness” or eye bag can increase with extra salt intake for example after eating salted popcorn or salty food, as the extra salt holds water in the eyelid fat. Beautiful corection of dark circles is possible.
Dark circles under the eye are caused by the fact that the eyelid tissue is attached to the bone of the eye socket by a structure called the arcus marginalis, thus the skin and bulging fat, the eye bag, fall down over the area where the arcus marginalis is attached to the bone thus creating a shadow or dark circle under the eye. (See chapter1- Is That My Mother I See In The Mirror, in Save Your Face).
No skin cream, tea bag or any other remedy other than surgery will correct eye bags and dark circles under the eye.
The eyelid rejuvenation operation called a blepharoplasty or “eyelid tuck” is often done to correct bags and dark circles under the eyes, but if the arcus marginalis is not released, the dark circles under the eyes can get worse. During this procedure the bulging fat is removed and the attachment of the eyelid to the bone is released (an arcus marginalis release) and sometimes extra skin is removed or tightened with the laser.
There are two ways to do this operation and they have some VERY IMPORTANT differences. I do the operation with a laser to minimize bleeding and bruising and I make my incision on the INSIDE of the eyelid, through the pink part of the inside of the lid, the conjunctiva, called a transconjunctival blepharoplasty. I remove and reposition the fat, release the arcus marginalis attachment to the bone, and tighten the eyelid with the laser from the inside. This is called the transconjunctival laser blepharoplasty.
The reason I use this approach is that it avoids making an incision on the outside of the eyelid.
The disadvantages of making an incision on the outside of the eyelid are two:
- An outside incision leaves a visible scar on the eyelid.
- An outside incision weakens the eyelid which can result in a change in the shape of the eyelid to a sad down turned look.
The advantages of the transconjunctival laser blepharoplasty with arcus marginalis release are:
1.No change in eyelid shape
2.Removal of the dark circle under the eye
3.Less bleeding
4.Less bruising
5.Quicker recovery
It is important when you have eyelid rejuvenation surgery for eye bags and dark circles under the eyes that you see a plastic surgeon who is very experienced in eyelid surgery.
For more infromation on dark circles under the eyes visit my Boston Plastic Surgery Practice, contact me or read Save Your Face.
Sincerely,
Dr.Seckel
Boston, Massachusetts
Peabody, Massachusetts