Arcus Marginalis Release to Correct Dark Circles Under Eyes
Skin creams, vitamins, cucumber juice and plenty of sleep will NOT correct bags and dark circles under your eyes, often the first sign of facial aging. I am talking about that deep dark circle below the eyelid just above your cheek. The dark circle under your eye, called the naso-jugal fold or tear trough deformity is a structural problem caused by the attachment of your eyelid muscle to the bone of your orbit, the bony socket which supports your eye.
The skin of the lower eyelid is tightly attached to this muscle and is tethered with the muscle to the underlying bone. The surrounding eyelid skin and cheek skin is not tethered, is looser and hangs over the naso-jugal fold creating a dark shadow, which is the “dark circle under the eye” or tear trough deformity.
The most effective way to correct bags and dark circles under the eyes is a plastic surgical procedure called an arcus marginalis release. The arcus marginalis is a small condensation of eyelid tissue which holds the eyelid tightly to the orbital bone and creates the dark circle under the eye. During the operation the arcus marginalis is cut or released and the eyelid tissue is free to slide down a small amount and the dark circle disappears. Typically a small amount of fat or other material is placed on top of the orbital bone to “plump up” the dark circle and prevent the eyelid from re-attaching and creating the dark circle or naso-jugal fold again.
I remove dark circles under the eyes by performing the arcus marginalis release through a transconjunctival incision-that is through an incision on the inside or pink part of the eyelid. The benefit of this is that there is no visible scar on the eyelid. Another benefit is that the supporting skin and muscle of the eyelid is not violated by an external incision, thus the eyelid shape does not change after surgery. Often when an external eyelid incision is used the eyelid shape changes creating a “sad eyed” or “hound dog eyes” appearance to the eyes.
Fat injection has also be used to improve the dark circles under the eyes. Recently some doctors have injected fillers such as Restylane® to improve dark circles under the eyes, but these injections have to be repeated every 6-9 months. I also worry that if the filler or fat is accidentally injected into the blood vessels feeding the eye, the vessels may be blocked and the eye damaged, possibly causing blindness. There have been problems with noticeable lumps on the eyelid following injection techniques for dark circles under the eyes.
For a review of this and other eyelid rejuvenation techniques visit www.saveyourface.com and check the “Ask Dr Seckel” archives under transconjunctival blepharoplasty, dark circles under eyes, eyelid bags, laser blepharoplasty, and eyelid rejuvenation.
Always be sure to consult a board certified surgeon who is experienced in eyelid surgery for this or any other eyelid rejuvenation surgery. For more information contact me or call 617-262-2208 or read Save Your Face.
Boston, Massachuisetts