Dark circles under the eyes are very common throughout the world and affect all races. Although the skin of the lower eyelid is a darker, often purplish color in all people, which is normal, by dark circles under the eyes I am referring to a dark, shadowed depression below the lower eyelid which is common and affects many individuals at all ages and of all races. I call this dark circle under the eyelid the arcus deformity because the dark circle depression is caused by the attachment of the arcus marginalis, a structure beneath the eyelid skin which tethers the lower part of the lower eyelid to the bone of the eye socket, creating a depression below the lower eyelid which creates a shadow which is the dark circle under the eye. (Contact Dr Seckel)

In people from India and Central Asia and the Middle East however, the arcus deformity takes on a different appearance than that in people of other races in that there is an additional slight depression in the bone below the eye socket which creates a deeper and wider dark circle under the eye which adds a hollow look to the eye in addition to the dark circle under the eye. The combination of dark circles under the eyes and the hollow eyed look must be recognized if proper correction is to be achieved.

The standard operation which I do to correct dark circles under the eyes is called a transconjunctival laser arcus marginalis release with fat repositioning or fat grafting. This operation works extremely well to correct dark circles under the eyes in most Caucasian patients, however it will not adequately correct the hollow look which accompanies dark circles under the eyes in people form Central Asia who have dark circles under the eyes and hollow eyes.

To correct the specific type of hollow dark circles under the eyes in people from India and Central Asia and the Middle East, additional fat grafting must be done on the anterior surface of the upper maxilla or cheek bone to adequately correct the hollowness. Alternatively an implant can be used but the tear trough implant commonly used is not always the proper configuration and must be augmented with additional composite fat grafts.

With globalization and the phenomenal economic success of India, Central Asia, and the Middle East many people from these areas of the world are emigrating to the West and seeking aesthetic correction of dark circles under the eyes in the US. It is very important that these people understand the unique nature of dark circles under the eyes in Indian people and the need for specific, custom eyelid procedure required to achieve a desired aesthetically pleasing result. The standard western blepharoplasty which is practiced widely in the US and Europe today will actually make the dark circles under the eyes and the hollow eye appearance worse when performed on the Indian eyelid. An arcus marginalis release alone will not correct the problem.

For further information on eyelid and facial rejuvenation read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

This entry was posted on Saturday, July 7th, 2007 at 1:50 pm and is filed under Eyes. Both comments and pings are currently closed.