What's New » Eyes

Eye Bags-Modern Removal Techniques

Dr. Seckel — Fri, 29 Feb 2008 09:29:29 +0000

The eyes are the “window to the soul” and our most frequently viewed facial feature and unfortunately the first feature to show the signs of facial aging. Usually by the 30’s we begin to see crow’s feet, wrinkles, eye bags, dark circles under the eyes, and the start of eyelid hoods or hooding of the eyes.

(Contact Dr Seckel)

Traditional plastic surgery called the blepharoplasty can remove eye bags and reverse many of these eyelid aging changes however newer methods using laser blepharoplasty and other laser eyelid rejuvenation techniques are vastly improved methods for eyelid rejuvenation and removal of eye bags. Newer, non-surgical eyelid rejuvenation techniques such as Botox and non-surgical eyelid skin tightening techniques such as the Aluma radiofrequency skin tightening device can improve and help prevent eyelid skin aging changes such as wrinkles and crow’s feet but removal of eye bags requires surgery.

The laser eye lift, which I call the “modern blepharoplasty”, combines new laser and non-surgical skin rejuvenation technology to produce dramatic eyelid rejuvenation and removal of eye bags without many of the drawbacks of traditional blepharoplasty.

Contact Dr Seckel

The laser eye lift combines the advantages of nearly bloodless laser incisional methods with non-surgical skin tightening and skin peeling methods for removal of eye bags as well as wrinkles and tightening and freshening of the eyelid skin. For the first time we can achieve total eyelid rejuvenation, not just removal of eye bags and hooding of the eyes, but smooth young looking eyelid skin with fewer wrinkles and less sun damage and aging changes and removal of dark circles under the eyes.

In addition by using the laser to make a tiny incision on the inside of the lower eyelid (the transconjunctival blepharoplasty) we can avoid a visible scar on the outside of the lower eyelid. The transconjunctival blepharoplasty technique also avoids any change to the beautiful lower eyelid shape, a common and troublesome complication of traditional scalpel blepharoplasty with an external eyelid incision. In addition, with the transconjunctival blepharoplasty it is possible to release the arcus marginalis and thus remove dark circles under the eyes as well as eye bags.

Advantages of the laser eyelid rejuvenation are:

Faster Surgery
Less bleeding
Less Bruising
Quicker Recovery
No visible scar on lower eyelid
No change in lower eyelid shape
Removal of Puffy Eyes, Eye bags, and Dark Circles Under Eyes
Freshening of Lower Eyelid Skin with Skin Tightening and Wrinkle Removal

The laser eyelift consists of 4 steps:

Laser upper blepharoplasty for removal of hooding of the upper eyelid
Transconjunctival lower blepharoplasty with arcus marginalis release and repositioning or grafting of fat to remove the dark circles and bags under the eyes
Laser tightening of the lower eyelid and a procedure called canthoplasty to tighten the lower eyelid and remove eye bags
Lux2940 Fractional Erbium Laser eyelid skin peel to remove wrinkles, sun damage , and tighten lower eyelid skin

The combination of these 4 steps provides removal of eye bags and truly total eyelid rejuvenation for the first time, something which the traditional scalpel blepharoplasty just cannot achieve. Furthermore with the advantages of less bleeding and bruising, recovery time is usually shorter than with traditional scalpel blepharoplasty.

During step 1of the laser blepharoplasty, the laser is used to remove the loose upper eyelid skin which is creating the eye hoods. After the loose skin is removed access is gained to the canthal ligament, which supports the lower eyelid, through the upper eyelid incision, so that the lower eyelid may be tightened in step 3 to restore the shape of the lax lower eyelid.

Step2, the transconjunctival laser blepharoplasty removes bags under eyes, puffy eye, and dark circles under eyes. The conjunctiva is the pink portion of the inner lower eyelid, thus when the laser incision is made on the inner side of the lower eyelid it is called a transconjunctival incision. This approach avoids a visible scar on the outside of the lower eyelid. In addition, the supporting skin and muscle of the lower eyelid is not violated and thus the beautiful shape of the eyelid is not changed. One major drawback of traditional scalpel blepharoplasty is weakening of the lower eyelid and a downward turn of the eyelid referred to as an ectropion, also called the sad eyed look or hound dog eyes. The transconjunctival blepharoplasty avoids this complication.

During step 2 the eyelid fat which is causing the eye bag in either removed or repositioned so that it no longer causes the puffy eye bulge or eye bag. In addition, the arcus marginalis, a condensation of eyelid tissue which tethers the lower eyelid skin and causes the dark circle under the eye, is released allowing the dark circle to ‘open up”. In addition fat is placed beneath the dark circle to plump the dark circle. The combination of fat repositioning and arcus marginalis release remove the dark circles under eyes.

Step 3. During step 3 the laser is used to tighten the lower eyelid skin by shrinking the lower eyelid tissues through the transconjunctival incision. In addition, the canthal ligament, which supports the lower eyelid, is tightened with a suture placed through the upper lid incision, a procedure called a canthopexy. These two procedures tighten the lower eyelid and also provide a small amount of upper cheek lift.

Step 4. Step 4 involves refreshing, smoothing, and tightening of the lower eyelid skin using the Lux2940 Fractional Erbium laser eyelid peel. This new high tech procedure allows for rejuvenation of the skin surface of the lower eyelid and thus total eyelid rejuvenation. In the past with traditional laser blepharoplasty, hoods and bags were removed but the eyelid skin remained wrinkled and old looking. With today’s new laser blepharoplasty and eyelid rejuvenation techniques a truly fresh and rejuvenated eyelid appearance is possible.

The laser eye lift is the modern blepharoplasty approach which provides total eyelid rejuvenation. For further information read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

978-369-4499

Your Tired Eyes-What causes them and how to correct Tired Eyes

Dr. Seckel — Fri, 29 Feb 2008 09:17:08 +0000

The eyes are the window to the soul; our most often noted and viewed facial feature, and unfortunately the first facial feature to show signs of facial aging. Eyelid aging changes begin as early as the late 20’s and early 30’s and are one of the most common concerns that motivate people to seek plastic surgery. The most common sign of eyelid aging is “tired eyes” and the most common complaint I hear is that “people say I look tired and I am not”. Blepharoplasty, the plastic surgery procedure to correct aging eyes is the 3^rd most common plastic surgery procedure performed in the United States today

Happily there are many preventative steps we can take to prevent eyelid aging changes, and if you already have aging eyes there are many exciting new non-surgical methods available to reverse eyelid aging changes.

The earliest eyelid aging changes are eyelid wrinkles called crow’s feet which we see on the corner of our eyelids on the cheek when we smile. Later these wrinkles extend across the lower eyelid and up into the upper eyelid. Later the upper eyelid skin becomes lax and begins to sag or droop and eventually covers the beautiful upper eyelid fold and begins to form an eyelid hood or eye hood which eventually can compress the upper eyelashes and obstruct vision. Eye hoods or eyelid hooding can also be made worse by the descent of the sagging eyebrow.

The lower eyelid also becomes lax and as a result, normal fat beneath the eyelid protrudes or pushes out on the eyelid and creates eye bags or eyelid bags or puffy eyes. This protruding lower eyelid tissue creates a shadow in the normal depression below the eyelid and creates the dark circles under the eye.

Fortunately there are many things we can do to prevent these eyelid aging changes before they occur or reverse these changes early without surgery. If however advanced eyelid aging changes occur, there are excellent modern laser and surgical eyelid rejuvenation procedures available to restore the eyelid to a youthful appearance.

Prevention of Eyelid Aging

Sun block, wrap around sun glasses, and general sun protection are essential eyelid aging prevention techniques, especially in the south, southwest and west where sun exposure is greatest and outdoor activities are so common. A healthy diet and exercise help prevent premature skin aging and tired eyes. Botox prevents crow’s feet. A good anti-aging skin cream like Retin A or vitamin C can help prevent and reverse eyelid skin aging and eyelid wrinkles.

Non-surgical eyelid rejuvenation

Exfoliation of eyelid skin, stimulation of new collagen formation in sun damaged eyelid skin, and tightening of eyelid skin can all be achieved non-surgically and can correct early eyelid aging changes and tired eyes. Topical Retin A, microdrmabrasion and Dermasound are good non-surgical eyelid rejuvenation techniques. For more severe eyelid aging, laser skin rejuvenation with newer less intensive eyelid laser skin peeling techniques such as the activefx laser skin peel or the microlaserpeel, or the lux2940 microfractional laser peel can exfoliate and tighten eyelid skin and remove eyelid wrinkles.

Surgical Eyelid rejuvenation

Modern eyelid rejuvenation surgery utilizes the laser and revolutionary new blepharoplasty techniques to rejuvenate the aging eyelid with minimal or no scarring and can correct tired eyes while preserving the beautiful eyelid shape. Surgical lower eyelid rejuvenation utilizes a laser incision on the inside of the lower eyelid through the pink portion of the eyelid called a transconjunctival blepharoplasty. During this procedure the eyelid fat is repositioned to remove the eye bag without creating a hollow eyelid appearance. Dark circles under the eyes are removed by a procedure called the arcus marginalis release, all with no scar. Upper eyelid hooding or eye hoods are also removed with the laser with virtually no bleeding, thus less bruising, quicker recovery and a small scar that is invisible when the eye is open. If wrinkles and sun damage of the eyelid are severe a new more gentle Lux 2940 microfractional laser skin peel can be done to smooth and freshen the eyelid skin for total eyelid rejuvenation.

With prevention, eyelid aging can be forestalled and early eyelid nagging can be treated with simple painless non-surgical high tech methods. Once eyelid aging has occurred remarkable truly revolutionary laser eyelid rejuvenation techniques are available to correct tired eyes, restore a youthful, open, alert, bright look to the eyes, the window to our soul.

To learn more about eyelid aging prevention, modern eyelid rejuvenation, and facial rejuvenation, read Save Your Face or contact me.

Thank you,

Dr Seckel,

Boston, Massachusetts

Puffy Eyes-How to Remove Eye Bags

Dr. Seckel — Mon, 08 Oct 2007 13:44:34 +0000

The eyes are the window to the soul

Our eyes are our most often noted and viewed facial feature, and unfortunately aging eyes are the first facial feature to show signs of facial aging. Eyelid aging changes begin as early as the late 20’s and early 30’s and are one of the most common concerns that motivate people to seek plastic surgery. Blepharoplasty, the plastic surgery procedure to correct aging eyes is the 3^rd most common plastic surgery procedure performed in the United States today. (Contact Dr Seckel)

Happily there are many preventative steps we can take to prevent eyelid aging changes, and if you already have aging eyes there are many exciting new non-surgical methods for eye rejuvenation available to reverse eyelid aging changes.

The earliest eyelid aging changes are eye wrinkles called crow’s feet which we see on the corner of our eyelids on the cheek when we smile. Later the eye wrinkles extend across the lower eyelid and up into the upper eyelid. Later the upper eyelid skin becomes lax and begins to sag or droop and eventually covers the beautiful upper eyelid fold and begins to form eyelid or eye hoods which eventually can compress the upper eyelashes and obstruct vision. Eye hoods or eyelid hooding can also be made worse by the descent of the sagging eyebrow.

Eyelid aging causes the lower eyelid to becomes lax and as a result, normal fat beneath the eyelid protrudes or pushes out on the eyelid and creates eye bags or eyelid bags or puffy eyes. This protruding lower eyelid tissue creates a shadow in the normal depression below the eyelid and creates the dark circles under the eyes, a hallmark of eyelid aging.

Fortunately there are many things we can do to prevent these eyelid aging changes before they occur or reverse eyelid aging changes early without surgery. If however advanced eyelid aging changes occur, there are excellent modern laser and surgical eye rejuvenation procedures available to restore the eyelid to a youthful appearance.

Prevention of Eyelid Aging

Sun block, wrap around sun glasses, and general sun protection are essential eyelid aging prevention techniques, especially in the south, southwest and west where sun exposure is greatest and outdoor activities are so common. A healthy diet and exercise help prevent premature eyelid skin aging. Botox prevents crow’s feet. A good anti-aging skin cream like Retin A or vitamin C can help prevent and reverse eyelid skin aging and eyelid wrinkles.

Non-surgical eyelid rejuvenation

Exfoliation of eyelid skin, stimulation of new collagen formation in sun damaged eyelid skin, and tightening of eyelid skin can all be achieved non-surgically and can correct early eyelid aging changes. Topical Retin A, microdermabrasion and Dermasound are good non-surgical eye rejuvenation techniques. For more severe eyelid aging, laser eyelid rejuvenation with newer less intensive eyelid laser skin peeling techniques such as the activefx laser skin peel or the microlaserpeel can exfoliate and tighten eyelid skin and remove eyelid wrinkles. New skin tightening treatments with the Aluma with FACES radiofrequency skin tightening machine can tighten sagging eyelid skin.

Surgical Eyelid Rejuvenation

Modern eyelid rejuvenation surgery utilizes the laser and revolutionary new blepharoplasty techniques to rejuvenate the aging eyelid with minimal or no scarring while preserving the beautiful eyelid shape. Surgical lower eyelid rejuvenation utilizes a laser incision on the inside of the lower eyelid through the pink portion of the eyelid called a transconjunctival blepharoplasty. During this procedure the eyelid fat is repositioned to remove the eye bag without creating a hollow eyelid appearance. Dark circles under the eyes are removed by a procedure called the arcus marginalis release, all with no scar. Upper eyelid hooding or eye hoods are also removed with the laser with virtually no bleeding, thus less bruising, quicker recovery and a small scar that is invisible when the eye is open. If wrinkles and sun damage of the eyelid are severe a new more gentle ActiveFX laser skin peel can be done to smooth and freshen the eyelid skin for total eyelid rejuvenation.

With prevention, eyelid aging can be forestalled and early eyelid sagging can be treated with simple painless non-surgical high tech methods. Once eyelid aging has occurred remarkable truly revolutionary laser eyelid rejuvenation techniques are available to restore a youthful, open, alert, bright look to the eyes, the window to our soul.

To learn more about eyelid aging prevention, modern eyelid rejuvenation, eye rejuvenation, and facial rejuvenation, read Save Your Face or contact me.

Thank you,

Dr Seckel,

Concord, Massachusetts

Boston, Massachusetts

978-369-4499

Reason For Dark circles Under Eyes

Dr. Seckel — Mon, 08 Oct 2007 11:42:40 +0000

To better understand the treatment of dark circles under the eyes I will discuss the various types of dark circles under the eyes that I encounter in my plastic surgery practice and my understanding of the cause of the dark circles, and what I feel is the most effective treatment to remove the dark circles under the eyes.

Understand that the eyelid skin appears darker than the surrounding facial skin in all people-this is the normal condition and is caused by shadows created by the overhanging brow and the fact that the eyelid skin is much thinner than the surrounding facial skin. Below I am talking about exaggerated dark circles under the eyes that cause people to be unhappy with their appearance.

Causes of Dark Circles under the Eyes

Thin Eyelid Skin

The eyelid skin is the thinnest in the body and many people with dark circles under the eyes have extremely thin skin on their eyelids and around the eyes. This thin skin is an inherited trait. The dark circles under the eyes are caused by the fact that the purple color of the underlying eyelid muscle shows through the thin skin and creates a bluish or purple color. The color is darkest near the nose and on the lower eyelid near the nose.

Treatment of dark circles under the eyes caused by thin skin is very difficult because it is very difficult to make your inherited skin thicker. Cover up make up like Jayne Iredale Eye Cover, Dermablend, and Covermark are very helpful and my first recommendation. Frequent microdermabrasion and Retin A cream over a long period of time will build new collagen in the dermis will thicken the skin and provide some improvement.

There are new lasers on the horizon which are very effective at stimulating new growth of collagen in the dermis and these new technologies may prove very beneficial. Be sure to sign up for my free newsletter to be informed when these new technologies are available.

The Arcus Deformity discussed below creates a very severe dark circle in people with thin eyelid skin and correction of the Arcus deformity with Arcus release and fat grafting can be very helpful treatment for dark circles under the eye in these individuals.

Prominent Eyelid Blood vessels and Veins

Everyone has veins and blood vessels called capillaries in their eyelid skin. In many people however the veins are very prominent and the blood vessels add to the dark color of the eyelid.

To diagnose this cause of dark circles look in a mirror with bright light on your face and gently pull the skin of the lower eyelid tight. You will see many tiny branching red and blue lines which represent blood vessels.

You need blood vessels and veins to keep your eyelid healthy and alive. However when there is an abundance of smaller vessels which create a bluish or purplish hue to the lower eyelid some new IPL (Intense Pulsed Light) or laser therapies can be used to treat dark circles under the eyes in people with an excess of small capillaries and blood vessels. The very large veins cannot be treated.

Laser blood vessel treatment is a serious and potentially dangerous treatment for dark circles under the eyes and must be performed by a physician who is experienced in the use of lasers and IPL. Most importantly the eye must be protected by placing a shield over the eye during treatment so that the laser or IPL light cannot hit the eye. The laser and IPL light can damage the retina and destroy vision if the beams hit the unprotected eye.

Pigmentation of the Eyelids

Hyper pigmentation, too much pigment in the skin of the eyelid is a very common cause of dark circles under the eyes. Treatment of dark circles under the eyes caused by hyper pigmentation is very effective, but the pigment frequently returns after sun exposure.

Hyper pigmentation of the lower eyelids occurs because of sun exposure and prevention with sun block, sun glasses, and a hat are the most important first treatment for this type of dark circles under the eyes.

The treatment of hyper pigmentation begins with bleaching creams such as a combination of Retin A and 4% Hydroquinone, Obagi Blender 5, Epiquin or other prescription bleaching cream combined with microdermabrasion.

After the above treatments have lessened the pigmentation causing the dark circles under the eyes, if necessary I proceed to IPL (Intense Pulsed Light) treatments. These treatments do effectively remove pigment causing the dark circle but again experience and eye protection are very necessary to prevent eye injury.

Hollow Eyes

Many people have a deep hollow beneath the lower eyelid which creates a dark shadow beneath the eyelid which people call dark circles under the eyes.

This deep hollow beneath the lower eyelid is caused by an inherited deficiency of fat and or bone and treatment of this type of dark circle under the eye requires surgery.

The hollow eye occurs more commonly in people from Central Asia and the Middle East but it certainly occurs in all races and from people in all regions of the world.

To treat dark circles under the eyes in people who have hollow eyes I do a laser procedure called an Arcus Marginalis release and fat grafting. The Arcus Marginalis is a structure which tethers the lower eyelid to the bone and creates a dark circle when the eyelid skin above the dark circle falls over the dark circle creating a shadow. Releasing the Arcus Marginalis releases the eyelid skin and eliminates the crease or dark circle.

I then transplant fat to fill the hollow in the bone and plump the dark circle and correct the hollow eye appearance.

Usually, to treat the dark circle under the eyes caused by the hollow eye I have to take fat from around the belly button on the abdomen to have enough fat to adequately fill the hollow eye deformity. The incision to remove the fat is well hidden down inside the belly button and is usually not visible.

Treatment of dark circles under the eyes caused by the hollow eye usually takes me 45 minutes to an hour, can be done with you asleep or awake, and recovery is usually 10 days. Patients do not complain of pain afterwards. The main recovery is waiting for bruising to go away and blurred vision from eye ointment that I have you use for the first week or two. Most importantly after this treatment you need to be calm, rest and not exert yourself. Working out or heavy lifting can raise your blood pressure and cause bleeding. Although you will be up and around the first few days with sunglasses to cover your bruising, I do not want you to exercise or lift heavy objects for at least 2 weeks.

The Arcus Deformity-the True dark Circle under the Eye

The most common cause of dark circles under the eyes in patients who seek treatment of dark circles under the eyes in my plastic surgery practice is the Arcus Deformity.

The Arcus Deformity is a dark crescent shaped circle or depression which occurs beneath the lower eyelid starting beside the nose in the corner of the eye and running out toward the side of the face and curving upward towards the outside corner of the eye.

The Arcus Deformity is caused by the fact that a small structure beneath the lower eyelid called the Arcus Marginalis is attached to the bone of the eye socket and also attached to the lower eyelid from underneath. This attachment tethers or holds the eyelid close to the bone of the eye socket while the rest of the lower eyelid is loose and free to move. The normal fat which is beneath the eyeball pushes out against the lower eyelid which creates a visible bulge on the lower eyelid. You can see this by closing one eye and gently pressing on the closed eye. With your other eye you will see the bulging of the fat against the closed lower eyelid on the other side.

The eyelid skin that is tethered by the Arcus Marginalis cannot move or bulge, and as the fat bulges the lower eyelid above the Arcus Marginalis it creates a shadow or dark circle beneath the eyelid where the Arcus Marginalis is attached to the lower eyelid skin. This is the true dark circle under the eyes.

As we age and our eyelid skin becomes loose or lax, the eyelid skin also falls or sags over the depression caused by the Arcus deformity and the dark circle gets worse. With aging and excess protrusion of fat against the lower eyelid the Arcus deformity can become quite pronounced.

The Arcus Deformity is the true dark circle under the eye and I use the term Arcus Deformity to differentiate it from the Tear Trough Deformity which is different. The Tear Trough Deformity starts near the corner of the eye in the same location as the Arcus Deformity but the Tear Trough Deformity runs down into the cheek rather than up toward the outside corner of the eye.

The Tear Trough Deformity is a sign of advanced facial aging and is caused by the sagging or descent of the cheek into the middle of the face which occurs with facial aging in your 50’s and 60’s. Tears run down the cheek and out the side of the face through the Tear Trough instead of straight down the cheek as they do in a child.

By contrast the Arcus Deformity occurs in much younger patients including children. Most people seeking treatment for dark circles under the eyes in my plastic surgery practice are in their 20’s and 30’s. Doctors often misdiagnose the Arcus Deformity as the Tear Trough Deformity which is a major problem if a Tear Trough Implant is used to treat the dark circle. The Tear Trough Implant is designed to plump or correct the depression in the cheek out toward the side of the face, and in my experience the Tear Trough Implant cannot adequately correct the dark circle under the eye where it is deepest, near the corner of the lower eyelid near the nose.

The treatment for dark circles under the eyes caused by the Arcus Deformity must include release of the Arcus Marginalis and fat repositioning or fat grafting to plump the area of the dark circle.

The traditional plastic surgery treatment for eyelid rejuvenation called the blepharoplasty, during which fat is removed, can actually make dark circles under the eyes worse and create a hollowed eye appearance.

Treatment of dark circles under the eyes that are caused by the Arcus deformity requires a modern blepharoplasty approach which includes release of the Arcus Marginalis and fat repositioning or fat grafting.

I use a very specific treatment for dark circles under the eyes called the transconjunctival blepharoplasty with Arcus release and fat grafting. This treatment is done through a tiny incision on the inside of the eyelid called a transconjunctival incision because it goes through the conjunctiva, the pink tissue on the inside of the lower eyelid. I also use the laser to make this incision.

The benefits of the laser transconjunctival incision are:

No visible scar or incision on the outside of the eyelid
No change in the shape of the lower eyelid-the traditional scalpel blepharoplasty through an external incision usually weakens the lower eyelid and causes a sad eyed look
Less bleeding during surgery
Less bruising after surgery
Quicker recovery

My results following treatment of dark circles under the eyes with the laser transconjunctival blepharoplasty with Arcus Marginalis release and fat grafting have been very successful. Most patients have recovered within a week and many who do not bruise are comfortable being seen with make up after 5 days.

Summary- Treatment of Dark Circles under the Eyes

To summarize, effective treatment of dark circles under the eyes requires that you correct the problem that is causing the dark circle under the eye. To accomplish this you must understand what type of dark circle under the eye you have and what is causing it. The following is a summary table:

Cause of dark Circle	Treatment of dark circle
Thin eyelid skin	Retin A, microdermabrasion, laser?
Prominent Eyelid Blood Vessels	IPL, Laser
Pigmentation of the Eyelid	Bleaching creams, IPL, laser, Microdermabrasion
Hollow Eyes	Arcus Marginalis Release and fat Grafting
Arcus deformity	Transconjunctival laser Blepharoplasty with Arcus release and fat grafting or repositioning

Treatment of dark circles under the eyes is possible; the key is understanding the underlying cause of your dark circles. With proper diagnosis and treatment of dark circles under the eyes caused by the Arcus deformity beautiful results can be achieved with the transconjunctival Arcus release and fat grafting.

For more information on dark circles under the eyes contact me and feel free to send me photos of your eyes and I will tell you what I see after reviewing them.

Be sure to sign up for my free email newsletter as I often write about dark circles under the eyes and other topics on facial rejuvenation. I suggest you read my book Save Your Face which explains facial and eyelid aging and how to reverse and treat facial aging changes.

Dr Brooke R. Seckel

Concord, Massachusetts

978-369-4499

Remove Dark Circles Under Eyes

Dr. Seckel — Mon, 08 Oct 2007 11:21:40 +0000

Millions of people are bothered by dark circles under the eyes and spend millions of dollars on dark circle eye creams and other remedies that simply do not work. While cover up make up such as Dermablend can help, people with dark circles under the eyes complain that the make up looks unnatural and that the daily routine of cover up is a nuisance. (Contact Dr Seckel).

Interestingly, in my Boston Plastic Surgery Practice most patients who come to me complaining of dark circles under the eyes are younger people in their 20’s and 30’s who state that they have always had dark circles under their eyes since childhood. Dark circles under the eyes are not a complaint I hear from older patients. Older patients with aging changes of the eyelids complain of eyelid wrinkles, bags and dark circles under the eyes, loose skin and hooding of the upper eyelids.

Thus, in my opinion, dark circles under the eyes are less of an aging problem and more of an inherited structural problem of the lower eyelid which I call the arcus deformity. This structural problem, the arcus deformity, the true dark circle under the eye can be permanently corrected by a new modern blepharoplasty technique which is quick, effective, and leaves no visible scar on the eyelid and does not change lower eyelid shape.

People who have the arcus deformity or dark circles under the eyes do develop worsening of the dark circles under the eyes as they age, and in the late 40’s and 50’s develop a condition called the tear trough deformity or crescent deformity. In my experience, if patients have the dark circles under the eyes or arcus deformity corrected when they are younger, they will not develop the more severe tear trough deformity as they age.

To understand how to permanently remove dark circles under the eyes, it is important to differentiate the true dark circles under the eyes from other conditions which are mistakenly called dark circles under the eyes. All lower eyelid skin on every human being is darker than the other facial skin, often a purple color, because the eyelid skin is so thin you can see the purple color of the lower eyelid muscle through the skin. The purple eyelid color is not the true dark circle under the eye. Some people have brown pigment on the lower eyelids from sun damage, but this is also not a true dark circle under the eyelid. Some people have hollow eyes due to lack of normal fat beneath the eyeball or an abnormality of the eye socket, but this is hollow eye syndrome, not dark circles under the eyes.

The true dark circle under the eye is a depression or crease below the lower eyelid which is deepest and starts at the inside corner of the lower eyelid next to the nose, and runs out towards the side of the cheek. The dark circle crease lies on top of the bone of the eye socket, which is the bone you can feel with your finger at the top of your cheek just below the lower eyelid.

To understand how we can permanently remove dark circles under the eyes, we must understand how the dark circle is formed and what causes the dark circle under the eye. Dark circles under the eyes or the arcus deformity, are caused by the fact that the lower eyelid skin of the dark circle is attached to the underlying bone of the eye socket by a condensation of eyelid tissue called the arcus marginalis. Since the dark circle is tethered or attached to the bone, the dark circle cannot move freely with the rest of the eyelid. When the eyelid swells due to allergy or too much fluid retention, or when the lower eyelid becomes loose and sagging with eyelid aging, the dark circle stays tethered, and the eyelid skin above the dark circle falls over the tethered dark circle, creates a deep dark shadow, which is the true dark circle under the eye. All of us also have fat beneath the eyeball which pushes forward on the lower eyelid and creates a bulge above the dark circle under the eye and worsens the shadow which is the dark circle under the eye.

Permanent removal of the dark circles under the eyes requires that the arcus marginalis be released so that the dark circle skin is no longer tethered to the bone of the eye socket, so that the dark circle depression can “open up” or slide down with the rest of the eyelid skin. In addition the eyelid fat is repositioned or grafted beneath the dark circle or arcus deformity to plump the dark circle.

These techniques are part of what I call the modern lower eyelid blepharoplasty which is called the transconjunctival laser lower blepharoplasty with arcus marginalis release and fat repositioning or fat grafting. This operation is done through a small incision on the inside pink potion of the eyelid, called the conjunctiva, thus the term transconjunctival. By using this approach there is no visible incision on the outside of the lower eyelid. The additional benefit of the transconjunctival approach for removal of dark circles under the eyes is that the shape of the eyelid is not changed because the supporting structures of the lower eyelid are not damaged by an external incision.

Once the transconjunctival incision is made with the laser, the arcus marginalis is released, and the protruding lower eyelid fat is repositioned or grafted over the bone of the eye socket beneath the dark circle under the eye to plump the dark circle.

The transconjunctival laser blepharoplasty with arcus marginalis release and fat repositioning is a method for permanent removal of dark circles under the eyes. In addition, eye bags or puffy eyes are eliminated with this technique. An additional benefit is that further aging changes such as the development of the tear trough deformity are halted.

Dark circles under the eyes are a very common problem and are usually evident at a very young age. Permanent removal of true dark circles under the eyes, the arcus deformity, requires release of the arcus marginalis and fat repositioning or fat grafting. The transconjunctival approach for the correction of dark circles under the eyes provides the benefit of no visible scar and more importantly preserves lower eyelid shape.

To learn more about dark circles under the eyes and facial rejuvenation read Save Your Face or contact me.

Dr. Seckel

Boston, Massachusetts

Dark Circles under the Eyes in Models, Actors, Movie Actors, Hollywood film stars and Bollywood Stars-Premature Facial Aging that Can Harm a Movie or Modeling Career

Dr. Seckel — Sun, 15 Jul 2007 16:23:42 +0000

In this blog I am describing a new laser procedure which can have career saving implications for many models, actors, hollywood stars and bollywood stars as well as improve the appearance and self esteem of the millions of people worldwide are bothered by dark circles under the eyes.

This new procedure which I have developed produces dramatic correction of dark circles under the eyes and a beautiful eyelid rejuvenation result as shown in the pre and post laser procdure photo’s below (Contact Dr Seckel) :

Contact Dr Seckel

The advantages of this revolutionary new laser technique are:

Less bleeding
Less bruising
Quicker recovery
A much faster procedure

Interestingly most who complain of dark circles under the eyes are young, usually in their 20’s, and many are models, movie actors, Hollywood film stars, and Bollywood stars and starlets. Dark circles under the eyes are usually the first noticeable sign of facial and eyelid aging.

Dark circles under the eyes are also a serious problem for many average people, but particularly for models, movie film stars and starlets, actors, Hollywood stars, Bollywood stars and other people who are photographed or filmed by cinematographers for their livelihood.

This is because the lights used in movies and photography cast a very dark deep shadow into the dark circles under the eyes and makes the individual being photographed appear much older and tired. A 20 year old model , actor or movie star with dark circles under the eyes can appear to be in their 30’s or 40’s when filmed or photographed under these conditions and this can have devastating consequences for a modeling career, acting career or movie career.

Make up is not an adequate solution for dark circles under the eyes. Unfortunately, many models, actors and movie stars elect to have a plastic surgery operation called a blepharoplasty to correct dark circles under the eyes, and the traditional scalpel blepharoplasty as often performed in the US today can actually make the dark circles under the eyes worse and create a hollow eyed appearance.

I call the dark circle under the eye the Arcus Deformity because the dark circle is caused by the attachment of a structure called the arcus marginalis to the skin of the lower eyelid. The arcus marginalis tethers the eyelid skin to the bone of the eye socket and creates the depression or dark circle just below the eyelid above the cheek.

To correct the dark circles under the eyes I perform a laser procedure called an arcus marginalis release with fat grafting or fat repositioning. I do this operation through a small laser incision on the inside of the eyelid, called a transconjunctival blepharoplasty approach. The benefit of the transconjunctival incision is that there is no visible scar on the outside of the eyelid. More importantly there is no damage to the supporting structures of the eyelid so no change in eyelid shape occurs. Traditional scalpel blepharoplasty involves making an incision on the outside of the eyelid and damages the support of the eyelid and results in a sad eyed look or hound dog eyes appearance.

The laser transconjunctival arcus marginalis release avoids damage to the supporting structures of the eyelid and leaves the natural beautiful shape of the lower eyelid in tact, and as shown above, achieves a beautiful result.

Using the laser for the transconjunctival arcus release and fat grafting to remove dark circles under the eyes allows me to do this operation in 30-45 minutes with minimal bruising which is often gone in 5-7 days and can be covered with make up in 4-5 days.

Dark circles under the eyes can be a serious detriment to the career of models, actors, movie stars, Hollywood Stars, Bollywood Stars, and other people who make their living being photographed and filmed. Unfortunately dark circles under the eyes become noticeable in the mid to late 20’s, usually the most important and productive years in a modeling career or film career.

This simple, safe procedure could add years to the productive life of a model, actor, movie actor or film star and avoid the devastating consequences of an external scalpel blepharoplasty which could ruin a movie career, acting career or modeling career if the sad eyed look or hound dog eyes complication occurs.

For the average person who is troubled by dark circles under the eys, this new laser procedure can refresh the eyes and face and improve self esteem.

For further information on dark circles under the eyes, laser surgery, or facial rejuvenation read Save Your Face or contact me.

Dr Secke l

Boston, Massachusetts

Dark Circles under the Eyes in India-The Indian Arcus Deformity

Dr. Seckel — Sat, 07 Jul 2007 17:50:16 +0000

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

Dark Circles under the Eyes-The Arcus Deformity

Dr. Seckel — Fri, 08 Jun 2007 14:13:25 +0000

Millions of people young and old have dark circles under the eyes. Most have tried many remedies; creams and cover up make up and still are bothered by the dark circles under the eyes. Some have even had the plastic surgery operation called a blepharoplasty, only to find that the surgery has made the dark circles under the eyes worse. (Contact Dr Seckel)

The major problem causing the failure to correct dark circles under the eyes, in my opinion, is a lack of understanding of what actually causes dark circles under the eyes and the necessary steps that must be taken to correct the dark circles under the eyes.

The term dark circles under the eyes refers to a dark circular depression beneath the lower eyelid which starts near the corner of the eye near the nose and runs as a semicircle or crescent beneath the eyelid out toward the side of the cheek. The dark circle under the eye is in fact a shadow created by the depression in the lower eyelid skin caused by the fact that the eyelid skin in the dark circle under the eye is attached to the underlying bone of the eye socket, the skin is tethered, and the untethered looser skin above the dark circle under the eye bulges or hangs over the dark circle under the eye and creates the shadow.

The structure which tethers the dark circle under the eye to the bone of the eye socket and cheek is called the Arcus Marginalis, thus I call the dark circles under the eyes the Arcus Deformity.

It is important to differentiate dark circles under the eyes or the Arcus Deformity from another condition called tear trough deformity. The tear trough deformity is a more advanced form of the arcus deformity which occurs with aging of the face. As the face ages, the cheek skin becomes lax and falls and leaves a depression on the cheek bone which is connected to the arcus deformity, but the tear trough deformity is much more to the side of the face and slants downward. The importance of understanding the difference between the arcus deformity and the tear trough deformity is that correction of the tear trough deformity requires either a cheek lift to reposition the cheek skin higher on the cheek bone, or the use of a tear trough implant.

In contrast, correction of dark circles under the eyes, the Arcus Deformity, requires only an eyelid procedure which releases the arcus marginalis to correct the tethering of the lower eyelid and repositioning or grafting of a small amount of lower eyelid fat beneath the dark circle under the eye to plump the dark circle under the eye. This procedure can be accomplished through a tiny laser incision on the inside of the lower eyelid avoiding any visible scar on the eyelid. This procedure called a transconjunctival arcus marginalis release and fat repositioning is a minor, minimally invasive procedure which produces excellent correction of the dark circles under the eyes, very different and less extensive than the procedures required to correct the tear trough deformity.

In addition it is also important to distinguish dark circles under the eyes from Dark Purple Eyelid Color. Dark eyelid color is normal and affects all people. The lower eyelid skin on every human face is darker than the surrounding facial skin because the eyelid skin is so thin that the purple color of the lower eyelid muscle shows through the eyelid skin. This dark eyelid color cannot be corrected by any treatment on the eyelid skin by laser, IPL, or creams. In some people who have pigment from sun damage or who have many small blood vessels that contribute to the dark eyelid color, lasers can be used to lessen the color of the pigment or blood vessels

Dark circles under the eyes, the Arcus Deformity, are very common in all age groups and a very distressing aesthetic or cosmetic concern for many people, especially for young people. The most troublesome feature is that young, healthy people with dark circles under the eyes are told by friends that they look tired or drawn or sick. This is especially a problem for young models and other people who are frequently photographed, as the shadow created by the dark circles under the eyes stands out and is more noticeable in photographs.

New technology and knowledge has made effective correction or removal of dark circles under the eyes possible using a safe, minimally invasive laser procedure, the transconjunctival arcus marginalis release with fat repositioning.

It is crucial to understand what actually causes dark circles under the eyes, the Arcus Deformity, in order for the proper procedure to be done. In my experience tear trough implants are the wrong choice, they are designed to correct the tear trough deformity which is very different, is located more to the side of the face on the cheek, and the implants do not correct the dark circles under the eyes where they are most noticeable, near the inside corner of the eye near the nose.

For further information on dark circles under the eyes or non-surgical facial and eyelid rejuvenation read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Permanent Removal of Dark Circles Under the Eyes

Dr. Seckel — Thu, 24 May 2007 11:08:26 +0000

To learn more about dark circles under the eyes and facial rejuvenation read Save Your Face or contact me.

Dr. Seckel

Boston, Massachusetts

Aging of the Eyes- Eyelid Wrinkles, bags and dark circles under the Eyes, and hooding of the Upper Eyelids

Dr. Seckel — Thu, 03 May 2007 01:48:28 +0000

The eyes are the window to the soul

Our eyes are our most often noted and viewed facial feature, and unfortunately eyelid aging is the first facial feature to show signs of facial aging. Eyelid aging changes begin as early as the late 20’s and early 30’s and are one of the most common concerns that motivate people to seek plastic surgery. Blepharoplasty, the plastic surgery procedure to correct aging eyes is the 3^rd most common plastic surgery procedure performed in the United States today. (Contact Dr Seckel)

Prevention of Eyelid Aging

Sun block, wrap around sun glasses, and general sun protection are essential eyelid aging prevention techniques, especially in the south, southwest and west where sun exposure is greatest and outdoor activities are so common. A healthy diet and exercise help prevent premature eyelid skin aging. Botox prevents crow’s feet. A good anti-aging skin cream like Retin A or vitamin C can help prevent and reverse eyelid skin aging and eyelid wrinkles.

Non-surgical eyelid rejuvenation

Exfoliation of eyelid skin, stimulation of new collagen formation in sun damaged eyelid skin, and tightening of eyelid skin can all be achieved non-surgically and can correct early eyelid aging changes. Topical Retin A, microdermabrasion and Dermasound are good non-surgical eye rejuvenation techniques. For more severe eyelid aging, laser eyelid rejuvenation with newer less intensive eyelid laser skin peeling techniques such as the activefx laser skin peel or the microlaserpeel can exfoliate and tighten eyelid skin and remove eyelid wrinkles. New skin tightening treatments with the Aluma with FACES radiofrequency skin tightening machine can tighten sagging eyelid skin.

Surgical Eyelid Rejuvenation

To learn more about eyelid aging prevention, modern eyelid rejuvenation, eye rejuvenation, and facial rejuvenation, read Save Your Face or contact me.

Thank you,

Dr Seckel,

Boston, Massachusetts