In my opinion permanent correction or removal of dark circles under the eyes requires surgery not filler injections. The “gold standard” continues to be a procedure called the Transconjunctival Blepharoplasty with Arcus Marginalis Release and Fat Grafting. Results of this procedure can be very effective-see before and after photos below.
Recently many physicians have been treating dark circles under the eyes by using filler injections, most commonly with Restylane Hyaluronic Acid facial filler.
Benefits of this filler injection are reported to be:
• Non-surgical procedure • Reversible with time or Hyaluronidase Injection • Acceptable temporary results
Are Filler Injections Safe for Dark Eye Circle Removal?
While some very experienced Eyelid Surgeons are able to safely and expertly inject Restylane into the lower eyelid to plump the dark circle depression beneath the lower eyelid, many less experienced doctors are trying this new technique.
In my opinion a detailed surgical knowledge of eyelid anatomy is required to correctly and safely inject filler into the lower eyelid area into the proper location to correct the deformity safely. If the injection is not done properly several serious problems or complications can occur.
Problems that I have seen in patients who have consulted me after receiving filler injections into the lower eyelid include:
Dark Circle made worse– this is the most common complaint I have heard. If the filler is not placed properly the action of the lower eyelid muscle pushes the filler down and out of the depression, causing the filler to actually plump the high point or shoulder of the skin below the depression which makes the depression look deeper.
Visible grey lumps– often the filler is injected too superficially near the skin. When this is done, the filler can actually be seen through the thin eyelid skin and appears as a grey lump.
Lumps and bumps– improper injection of filler can cause visible lumps and bumps on the lower eyelid.
Persistent eyelid skin irregularities– although Restylane is supposed to dissolve in 4-6 months, many patients complain that bumps or irregularities in the eyelid skin persist for a year or longer. My assumption is that these irregularities are caused by scar tissue resulting from the injections.
Permanent discoloration– I have seen patients who had an unknown off label non approved filler injected into their eyelids who were left with permanent orange skin discoloration.
Serious Complications of Filler Injection into Dark Circles
Injection into Blood Vessels of Eye– if filler is accidentally injected into one of the blood vessels that supply the eye damage to the retina or eye can occur.
Blindness– blindness following these injections has been reported in the medical literature, the presumed mechanism is injection into a blood vessel.
Damage to Eyelid or Eye Muscles– the eyelid muscles and the muscles controlling eye movement are very delicate and complexly arranged in a very small tight space. Inadvertent injection into one of these muscles can seriously damage eyelid or eye function. Once again a very detailed surgical knowledge of eyelid anatomy should be a pre requisite for injecting anything around the eye.
Find an Experienced Eyelid Surgeon for Filler Injection to Correct Dark Circles Under the Eyes
There are expert Eyelid Surgeons who can achieve good safe results with this new technique. If you are considering this technique please find a Board Certified Plastic Surgeon or Occuloplastic Surgeon who is experienced at this technique and ask to see their results. Also ask about the risks and possible complications.
Also, explore your options and ask about the removal of dark circles under eyes using the “Gold Standard” surgical techniques.
To learn more about plastic surgery and the skin care procedures we perform, please contact our Boston office today.
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Assistant Professor of Surgery Harvard Medical School
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