Which treatment would remove my dark circles?
Mine are bad and hereditary.
My mom has them almost as bad as me.
I get enough sleep and eat a lot too.
No alcohol, no smoking.
Thank you for your question!
You submitted a single photo with a concern about dark circles under your eyes.
And fortunately, you don't have the confounding factors such as smoking that can certainly
make things worse.
You described a situation that this is basically a genetic trait.
Now I can tell you that there is certainly a lot to the genetic of dark circles that
limit our options and what we can do.
When a certain ethnic group and anyone with a darker than Mediterranean skin or even the
Mediterranean skin type, very often it is common to have dark circles under the eyes.
When I look at a patient with this concern, I break down the elements that contribute
to the dark circles that can be addresses as well as what level that they contribute
to the overall appearance of the eyes.
So we look at the lower eyelid.
We look at the pigmentation of the skin.
We look at the skin quality.
We look at the areas with relative hollowing.
In particular, we pay attention to an area called the tear trough.
The tear trough area is just the area where the edge of the eyelid meets the cheek area.
It's a very common term used these days and I look at the under eye area for puffiness
or under eyebags and I look at the area adjacent to the eyelid to cheek.
We call that the eyelid to cheek junction to look at the orbital rim or the bone under
the eye and the cheek volume.
So you can see, there are many levels to treat the under eye circles that can be approached
and addressed.
Many years ago and I've been in practice and performing oculofacial plastic surgery for
over 20 years, I can tell you that there were very few options and we would basically draw
up our hand.
But fortunately, these days we have some options and I would share with you how I approach
a situation like yours in my practice.
When we look at the hollowing component of the under eye circles, hollowing usually means
some type of volume enhancement.
We're fortunate to have a lot of fillers such as those in the hyaluronic acid family example
such as restylane.
Now restylane can be placed very strategically in the tear trough area.
That is an art and that is not done exactly the same between doctors.
So, there's an art to filling that space to help soften the depth and darkness and shadow
created by relative hollow.
In addition, we have been using a material that's derived from your own blood called
platelet-rich plasma.
Platelet-rich plasma is basically using the components for your blood that is required
for healing called platelets as well as the plasma which is rich in growth factors that
we have learned to use in a way to stimulate the quality of the skin.
You see, when there's a genetic dark circle under the eyes, if there is any benefit to
improving the circulation and collagen, then platelet-rich plasma is a very good treatment.
What we have done in addition is combine platelet-rich plasma with hyaluronic acid and have seen
a nice synergistic benefit.
It appears, based also in wound healing literature that's been established that the combination
of platelet-rich plasma with hyaluronic acid results in this wonderful volume enhancement
which is combination of many things that actually is more long term.
Although the response to these procedures vary from patient to patient, there is more
benefit when we get this more long term benefit because we are using your own platelet-rich
plasma to stimulate collagen and blood supply which is a healing response.
And so we have seen long term benefit which I feel at this point is superior to using
a filler alone and that's a very important distinction.
Much of this field of doing this type of work requires both the treatment and observation
of the response and no two patients respond the same way.
But I think that in your situation, it is worthwhile exploring platelet-rich plasma,
hyaluronic acid filler and the combination as a strategy to help you improve the dark
circles under your eyes.
Meet with qualified experienced cosmetic surgeons who perform these procedures and hopefully
you will get a result that you are happy with.
So I thank you for your question, I wish you the best of luck and thank you again for your
question.