Dark circles under your eyes can make you look tired, even when you’re not. It’s not uncommon for well-rested men and women—and even some children—to suffer from these unflattering shadows. What causes them? Genetics, high levels of pigmentation, and lifestyle factors such as smoking, alcohol use, and stress are all possible culprits. There are also some other causes you might want to consider:
- Nasal congestion – When you’re congested, the veins that drain away from your eyes to your nose may become swollen and darken, causing a shadowy look.
- Allergies – If your eyelids become puffy and swollen from an allergy, they can cast a shadow on to the skin below
- Sun damage – Those shadows could be minute deposits of excess melanin, the pigment that gives skin its color.
- The normal aging process. We lose facial fat and collagen as we age, causing the skin to thin out and making blue blood vessels under the eyes more apparent. It may also cause the lower eyelid to become more hollow-looking, sinking deeper into shadow; or it may allow the fat from behind the eyeball to bulge out into the lower eyelid and cast a shadow below it.
Treatment of Dark Circles
As both an ENT (ear, nose and throat doctor) and a facial plastic surgeon in new York City, Dr. Yagoda can do more than camouflage the symptoms of your dark under-eye circles—she can determine their cause and eliminate them by treating them at their source. Correction of the underlying functional or structural issues may be enough to reduce under eye circles. But, if your under-eye circles are determined to be purely cosmetic in nature, or if additional cosmetic treatment is required after the underlying medical problems have been addressed, Dr. Yagoda offers treatments that either separately or in combination are highly effective.
- Tr-EYE-umph! Dr. Yagoda’s signature three-step, non-surgical, total eyelid rejuvenation technique. It raises the upper lid, erases brow lines, diminishes crows’ feet, softens lower eyelid “bags” and evens out eyelid skin color—all without downtime, scars, or anesthesia. If your under-eye circles are caused by the aging process, sun damage, or deep under-eye hollows, this procedure can give you remarkable, albeit temporary, results.
- Lower eyelid Blepharoplasty, surgically rejuvenating eyelid surgery for lasting results.
- Clareon Intense Pulsed Laser (IPL) to absorb excess deposits of melanin, and to reduce fine blood vessels that are noticeable through the skin.
- Medium-depth peel to resurface under-eye skin and stimulate collagen production for a smoother texture and brighter, light reflective appearance.
Causes of Bulges and Bags
Bulges and fat bags underneath the eye cause an unwanted puffiness on the lower lid. To best explain undereye bulges, imagine that the bony area behind the eye is shaped like an ice cream cone on its side, with the eyeball itself as the scoop of ice cream on top. Between the scoop of ice cream and the very bottom of the cone is a soft area that is filled with fat. Through normal aging or genetics or a combination of factors, this fat can seep out through the lower lids, positioning itself as bags underneath the eyes.
Treatment of Bulges and Bags
In the old days, the most popular treatment was to take out all the fat entirely, but this can leave a person with a strange, hollow area underneath the eyes. Now, the treatment of choice is not to take out all the fat, but rather to reposition it so that the lower lid is less puffy and baggy. This is done in combination with a transconjuctival lower lid blepharoplasty. With this approach, there is no skin incision and the lower lid is left intact to maintain its youthful strength and position.
Causes of Ridges
Ridges under the eyes occur in those who may be in the sun often and don’t wear sunglasses, causing them to squint, or those who need corrective lenses but don’t have them, which can also result in squinting. Ridges may also occur if you don’t wear enough sun protection. Since there is a circular muscle encompassing the upper and lower lids, repeat squinting causes the muscle to hypertrophy (or enlarge) and the ridge is similar to a bulging bicep muscle.
Treatment of Ridges
Ridges are best treated preventatively, with proper education about sun protection and the damage that squinting can do. If you already have ridges, it is important to wear sun protection to prevent them from becoming deeper. There are also a number of ways to camouflage existing ridges, including fat transfer, fillers, and sometimes judicious surgical excision of the bulging portion of the muscle.
Causes of Hollows
Undereye hollows are often the result of prior surgery with excess removal of fat. They are also the result of genetic predisposition or the normal aging process. With age, the tissues of the cheek—i.e., the fat and soft tissue overlying the cheek bone and protecting it in cases of impact—drop, creating a hollow area underneath the eye.
Treatment of Hollows
Hollows under the eyes can be treated by repositioning the cheek surgically, by injecting filler or fat in this area of depression, or using Dr. Yagoda’s combination eye rejuvenation treatment, the Tr-EYE-umph!
If you’d like to get rid of under-eye circles, bulges, ridges, bags, or hollows, schedule your consultation with Dr. Yagoda in New York City today!