How can I treat the dark circles under my eyes?
Can you give me some ways to treat my eyes?
Thank you for your question!
You submitted several photos and you are asking a simple question: what to do about dark circles?
Well, at this point, there are a lot of options than we used to have many years ago.
I’m a practicing oculofacial plastic surgeon for over 20 years and I can tell you that
for many years, we have always been frustrated because a lot of times, the dark circles under
the eyes could not be managed with anything more than some kind of attempt to lighten
them with bleaching creams or some other type of external treatment.
Move the clock forward and in our practice, we’ve developed our own process of addressing
dark circles by first defining what the cause of the dark circles are.
So in your situation, I would say that the dark circles are the result of an area of
hollowing called the tear trough.
And this is a very common area that people are concerned about that it causes this crevice
or just this depth that makes the eyes look like they’re tired and there is hollowing.
In addition, when the skin is relatively thin, you’re practically seeing directly to the
bone or seeing right through towards the muscle.
Eyelid skin is the thinnest skin in the body and with this half a millimeter of thickness,
anything below the eyelid skin is almost transparent with the right anatomic factors that includes
light skin and very little thickness in the tissue.
For someone like yourself, we have had a lot of success using a combination treatment.
And the combination treatment is based on two concepts: one is addressing skin quality.
Skin quality under the eyes can be improved using a material we use commonly called platelet-rich
plasma.
Platelet-rich plasma is actually the growth factors and healing factors derived from your
own blood.
What we do is we draw blood like you would do in a lab or a doctor’s office and we
spin the blood and we concentrate the platelet-rich plasma and these healing factors stimulate
collagen and blood supply and improve the skin quality in a way that improves the thickness
and the overall healthiness of the skin.
So that address the skin quality part of the equation.
The second part, the most important part is the volume.
And with volume, what we use is a hyaluronic acid filler such as Restylane.
Now what we do very differently is there’s always an art to doing this and placement
and the viscosity of the hyaluronic acid is critically important.
So, what we’ve able to successfully do is combine the hyaluronic acid filler to fill
the tear trough with platelet-rich plasma to improve skin quality.
It’s been well documented in medical studies on wound healing is that there’s actually
a synergy when combing platelet-rich plasma with hyaluronic acid so that wounds would
actually heal better in combination.
We have observed the same thing in our practice in that this combination help make the under
eye area look better.
Now, what is a challenge here is not only the placement, getting the results that you
desire but also maintenance.
The hyaluronic acid will eventually break down and eventually disappear.
There is some evidence of some residual fibrovascular or tissue that actually is there for a longer
term but nonetheless, the bulk of the hyaluronic acid volume effect does require some maintenance.
What I’ve observed since the first FDA approval of hyaluronic acid, I believe back in ‘05
is that there’s actually a variability of how long it will last between individuals.
And certain factors can certainly cause an acceleration in the degradation such as cigarette
smoking.
If someone smokes, they tend to break everything down because between the carbon monoxide and
the free radicals and everything else and so damaging, it can cause a breakdown of the
material.
So we always observe our patients very closely.
We routinely do this first treatment and we see our patients 2 weeks later to make sure
everything looks right and we’ll see people on a regular basis so that we can see when
the material breaks down.
It has not been unusual for patients to come in every 6 months to have it done and there
have been patients where it lasted up to 2 years.
So I think that for your situation, a combination approach is exactly what we would do in our
practice would be to use hyaluronic acid and platelet-rich plasma.
Now what I also didn’t mention is that there is a role for external topicals such as retinols
and really good quality moisturizers.
Everything actually contributes and I always say that the whole actually more than the
sum of its parts.
And so this kind of like putting all the parts in the right way to get the maximal result.
At this point, I think it’s advisable for you to meet with experienced and qualified
specialists who do a lot of work in this under eye area.
There’s a lot of gimmicks lately about trying to improve the dark circles and a lot of it
have to do with topical creams and a lot of them have to do with various differentiations
that a lot of doctors use such as the use of blunt cannulas and other things that make
it seem like there’s a superiority there.
But reality is, the key is knowing the anatomy and knowing how to do this and having the
experience to formulate this combination in the most effective way and that comes just
from doing this a lot.
And so, with that being said, just meet with doctors and see if you’re comfortable and
try this solution.
It’s a relatively low risk solution since there isn’t a surgery or a permanent implant
or anything of that nature.
So I hope that was helpful, I wish you the best of luck and thank you for your question!