Dr. Seckel, Is there any surgery to correct dark circles under the eyes? I am 44yrs old I don’t have any eyelid bags however under my lower eyelids the skin is sunken in creating a dark circle under the eyelid. Dark circles under the eyes do run in my family. I do have a few fine lines on the eyelids. I have tried every topical cream available. I am desperate please help. Margaret, Canada
Dear Margaret,
Please do not be desperate there are many new effective treatments that can eliminate dark circles under the eyes. If you read Chapter 1 in my book Save Your Face you can learn what causes the dark circles under the eyes. In Chapter 9 I discuss the eyelid rejuvenation procedure used to correct dark circles under the eyes and show patients who have had the surgery.
Briefly, the eyelid muscle and skin are attached to the bone of the orbit or eyelid socket creating the depression called the tear trough deformity or naso-jugal fold, also commonly referred to as dark circles under the eyes. The surrounding eyelid skin and muscle is not attached, is loose and falls over the tear trough depression creating a shadow and thus a dark circle under the eye.
For eyelid rejuvenation and to remove dark circles under the eyes the tear trough attachment, called the arcus marginalis, be released and something placed beneath the dark circle depression in the skin on top of the eye socket bone to prevent the arcus marginalis from re-attaching to the bone and to plump up or fill the dark circle depression so that a shadow or dark circle will not recur.
Correction of dark circles under the eyes can be accomplished during a laser blepharoplasty, an eyelid rejuvenation plastic surgery procedure which is done to remove eye bags and other eyelid aging changes. I use a laser to do this eyelid rejuvenation operation through an incision on the inside of he lower eyelid, a technique called a laser transconjunctival blepharoplasty. The benefit of the laser transconjunctival blepharoplasty is that no scar is visible on the eyelid after the surgery.
During the transconjunctival blepharoplasty the arcus marginalis is detached from the eye socket bone and a graft is placed on the bone to prevent the arcus from re-attaching and causing the dark circle under the eye to appear again. Most commonly the graft placed on the bone is fat which has been removed to correct the eyelid bag.
Some plastic surgeons do fat injections using a needle to inject your own fat beneath the depression or dark circle to plump up the depression and correct the dark circle under the eye. The fat has to be removed from another part of the body, placed into a syringe and injected. This procedure avoids the blepharoplasty operation, but is still a surgical procedure which causes bruising and swelling and requires a 10 day to two week recovery period for the bruising to resolve. The injected fat does not always survive and may also cause lumps on the eyelid. It is a blind procedure and I do not use it.
Finally, recently some doctors have tried injecting a filler such as Restylane® into the dark circle under the eye to plump up the dark circle. This is a new technique and published studies on the effectiveness of this technique are not available. Also, a filler is not permanent and you would need repeat injections every six months or so. Also I am worried about the dangers of injecting any substance around the eye with a needle for fear that if the material is accidentally injected into one of the blood vessels which feeds the eye, the material could block the vessel and damage the retina of the eye and cause blindness.
The most important consideration if you are considering any procedure for correction of dark circles under the eyes is that you seek consultation with a board certified plastic surgeon who is very experienced in eyelid rejuvenation surgery. The procedures used to correct dark circles under the eye are very complex, potentially risky procedures and should not be done by any doctor who is not very experienced in eyelid surgery. The eye is a delicate, very complex, vital structure. Beautiful eyelid rejuvenation results can be safely achieved, but only by a very skilled plastic surgeon who has a great deal of experience with these sophisticated, delicate advanced techniques.
For further information on eyelid rejuvenation and non-surgical facial rejuvenation visit my Boston Plastic Surgery Website, read Save Your Face or contact me.
Sincerely,
Boston, Massachusetts
Peabody, Massachusetts