I have sagging dark circles under my eyes.
What options are available?
The area is not puffy but sunken in and dark.
I'm 28
Thank you for your question!
You’re 28 years old and you submitted several very helpful photos and you’re concerned
that your under eye area is dark and sunken.
So certainly, I can offer you my experience.
To give you a little background, I’m a cosmetic oculofacial plastic surgeon.
This means I’m a specialist in the eyes and cosmetic surgeon of the eyes.
My original first training was in eye surgery and super specialized training through the
American Society of Ophthalmic Reconstructive Surgery of eyelids and face.
I’m also board certified by the American Board of Cosmetic Surgery and I’ve been
in practice in Manhattan and Long Island for over 20 years.
So I can certainly explain a little bit about my development of how I approach this problem
over the 20 years.
Back when I first started in practice, we didn’t have as many options and we look
at someone who’s relatively young and had a similar concern and basically through up
our hands and say, well, this is genetics and ethnic.
And to a certain degree, that remains to be true because we can’t change genetics or
ethnic pigmentation on a long term basis but we have newer methods.
Now, traditionally, in our field, people approach dark circles with a limited few options and
particularly those options are geared to more lighter skin people.
So when we deal with lighter skin people, you have a lot of different options of using
different lasers and devices and peels which can be fairly effective.
But when you’re dealing with ethnic skin, that means someone who has an olive complexion
or more darker.
So there’s a wide spectrum we’re dealing with and many different shades of brown.
You cannot use those same methods and expect the same results.
The skin type is very sensitive.
Basically, if you get a little irritated with any type of procedure or chemical or anything,
the skin can potentially turn dark.
Well, over the past several years, we have found very good benefit using something called
platelet-rich plasma (PRP).
Platelet-rich plasma is derived from your own blood and what we have found is with the
use of platelet-rich plasma, which is concentration of your growth factors, the essential growth
factors that are used for wound healing.
So when you get a cut, the cut is initially healed and scab.
The scab is created by platelets.
So PRP is taking those wound healing factors.
And it sounds strange but it actually improve the skin quality under the eyes.
We’ve also been combining this, especially for those who have a sunken appearance, with
a hyaluronic acid filler such as Restylane.
Restylane, Juvederm, these are fillers that are made with something called hyaluronic
acid.
Now this material, depending in viscosity, has to be handled in a very meticulous way
to fill those hollow areas.
Now there is a real art to this and requires from my experience, a real deep understanding
of this area.
So what we often do is we combine the two.
There is definitely a published synergy in the wound healing literature of the benefits
of hyaluronic acid when combine with platelet-rich plasma.
Now the challenge for you is that it is something that has to be maintained.
In other words, you have to come back periodically to maintain it.
Now if this is of a high priority to you and being relatively young, it is probably useful.
People have come to our practice anywhere from twice to 4 times a year for this type
of treatment.
You have to kind of weight that in terms of the benefits that you’re looking for.
A lot of our patients have come to us who have tried topical creams, they tried makeup.
Very often, the makeup is a challenge for you because when you use makeup, you have
to often be aggressive and when you want to take off the makeup, you also have to be aggressive.
Also, people who have darker complexion, very often are challenged by looking natural with
makeup.
Very often, in order to cover one small area, you have to blend a lot more.
So this becomes tedious after a while.
So in summary, I think that from my experience, this is something that we would do for someone
like yourself in our practice for your skin type and age.
And it has been fairly successful for us that we have been very happy with its ongoing success.
The other thing that I can also add is that PRP does have long term benefits because it’s
building up skin quality, collagen and blood supply.
Now this is a clinical impression.
We haven’t done skin biopsy and skin samples but we look with our eyes and with critical
eyes, the patients can see and they really like the benefits they get from PRP which
we use in a variety of ways.
From me, it’s opening the next level of treatment using your own body’s intelligence
for wound healing but using it in a strategic way.
It doesn’t help everything but it certainly, we have been very pleased with the way it
helps our patients with dark circles and hollowing.
So again, the combination of hyaluronic acid for the hollow, platelet-rich plasma for the
skin quality and there’s a synergistic benefit.
So I hope that was helpful, I wish you the best of luck and thank you for your question!