Are you bothered by dark circles under your eyes? This is a common complaint from patients and the good news is, you can do something about it!
If volume loss in the tear troughs is a contributing factor to the darkness you are perceiving, a dermal filler can help to replace the lost volume. The above patient received 1 ml of Juvederm® Vollure, a half syringe per side. The amount of filler in this area varies depending on the amount of volume loss. Less can be more as an overfilled tear trough can have an aesthetically unnatural appearance. I utilized a cannula for this treatment to minimize bruising and risk of intravascular product placement. The product was placed below the muscle. A small amount of product was put in the upper medial cheek as well to create a buttress of support. Frequently, as we age, the tear trough extends in to the cheek (nasojugal groove) which can also be corrected with the filler.
In this case, the patient left the office with two tiny dots on her cheeks where a needle was used to create an entry point for the cannula. (full disclosure, even with a cannula there can be bruising) Otherwise, she was thrilled and felt she looked rested and rejuvenated after an easy 30 minute appointment!
There are scenarios in which the shadowing is due to the pigment in the skin as well as volume loss in this area. In those cases topical products can help lighten the skin slightly. Darkness under the eyes can be difficult to address due to the fact that the tissues here are quite a bit thinner than other areas of the face. Right under these tissues is muscle, which is slightly blue, and this can show through these thinner tissues. Vascular bodies in this area can also create shadowing. You can evaluate with your provider what can be addressed and what realistic expectations would be in your situation.
If you opt for filler under the eyes avoid medications and supplements that may thin your blood for 1-2 weeks before your appointment. (ibuprofen, aleve, aspirin, fish oil, vitamin E, etc) We use HA fillers only for tear trough volume as it has the highest safety profile for this area. HA (hyaluronic acid) can be dissolved if needed with an enzyme.
Lastly, the good news is, we find filler lasts quite a while in the tear troughs compared to other areas of the face. I have had patients who still look corrected at two years.