There are many different causes of dark circles under the eyes. Unless there is an underlying disease or circulatory problem, most conditions can be treated.
First, the patient is evaluated with a good history and examination. Patients who present with fluid accumulation under the eyes due to severe allergies and sinus problems are in the group that is not suitable for eyelid surgery or filling.
These methods are also not sufficient in patients in whom blackness-purple is caused only by dark skin color. In patients outside these groups, bruises under the eyes are usually caused by the hollowing between the lid and cheek.
In order for the light hitting our face to be reflected back brightly, the lid-cheek transition must be smooth; since the light will be reflected darkly from areas with irregularities, these areas appear black-purple.
Light Filling in the Treatment of Dark Circles Under the Eyes
Light filling gives very good results in these patients, especially if there is no significant fat bagging. Hyaluronic acid fillers or fat transfers injected into the hollow part aim to make the lid-cheek transition flatter. Since light reflects back brighter from a flatter surface, fillers under the eyes are generally known as ‘light fillers’. Light filling is a very reliable and effective method in hands that anatomically have a detailed command of the eye area, but in cases where this area is not mastered and especially when superficial application is performed, there may be a lifelong permanent swelling and bluish color reflection.
Generally, some amount of the drug is applied to the deep tissue in the first session and the rest of the filler is injected at the end of the 2-3 week period when the area fills day by day. With this application, the duration of effectiveness is approximately 2 years.
Light filling should not be applied in patients with very severe allergic constitution (asthma attack, severe hay fever), patients with lymphatic drainage disorder in the lower lid. In addition, if fat bags are prominent in the lower lid, if there is lid laxity, if there is a significant loss of elasticity in the skin, filler application is not appropriate, and the problem may even become more pronounced with filling. This distinction is made with a meticulous oculoplastic examination and it is decided which patient is suitable for filler and which patient is suitable for surgery. It is not right to force filling in patients who require surgery.
With the surgical method, bags, collapses, sagging and wrinkles can be corrected in a single session and a permanent detailed solution can be provided to this area for decades. After a comprehensive oculoplastic examination, it is determined how the surgery will be performed and which techniques will be used.
The technique to be applied to each patient differs according to the patient’s anatomical structure and needs. While there are cases where only the fat bags are replaced into the underlying space, there are also patients who need to shape the entire midface. During this surgery, the surgical technique popularized as ‘almond eye’ is applied as standard and the almond shape that the lower lid should normally have is achieved.
The surgery is usually performed through the pink tissue between the lid and the eye and there is no skin incision. Since the fat bags are simplified and placed in the lower socket, the bruising is eliminated and the lid-cheek transition is corrected. There may be swelling and bruising that may last for 1-2 weeks after the surgery, but if the person wishes, he/she can return to work life on the 3rd day, but not at a heavy pace.
Mesotherapy in the Treatment of Dark Circles Under the Eyes
Another treatment group for the treatment of dark circles under the eyes is mesotherapy. In mesotherapy, chemicals that remove bruising, nourish and improve skin quality are injected under the skin with needles. In PRP application in this group, platelets prepared from the person’s own blood are injected under the skin instead of chemicals. Most of the time, mesotherapy is a method that we use in addition to surgery or filling application.
Another method for lower lid bruises, bags and sagging is the bipolar radiofrequency-based accutite method. Especially in patient groups who never want to undergo surgery, who do not have severe enough complaints to undergo surgery, who have undergone surgery before but some changes have appeared after years; This method, which has recently become increasingly popular in people who expect a long-term effect close to surgery, is a method that is applied under the skin without incision, can continue its effectiveness for up to 5 years and the patient can return to normal life on the same day.