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Dr. Zoumalan's Blog - News and Updates

Dark Circle Treatment Benefits

Posted On 04/11/2017 by Dr. Christopher Zoumalan

Are you tired of seeing those dark and puffy circles under your eyes even after a good night’s sleep? Dark circles are often caused by a variety of eyelid issues. Some treatment options may require surgery but others may require in-office procedures. Here are the top dark circle treatments and their benefits:

Lower Eyelid Blepharoplasty

Also known as eyelid surgery, it is used to fix dark circles and remove bags underneath the eyes. This procedure is primarily done to remove the excess fat beneath the eye but it can improve the dark pigmentation as well.

There are two approaches to this procedure:

1) Transconjunctival: This technique makes an incision in the lower lid which provides direct access to the fat pockets. Theses fat pockets can either be removed through heat-induced sculpting or, if Dr. Zoumalan thinks appropriate, repositioned. Repositioning (or transposing) helps distribute some of the excess fat into areas that may have less volume. This technique leaves no scars.

2) Transcutaneous: In some cases, both excess fat and skin need to be directly removed. A transcutaneous blepharoplasty is done in cases where there is excess skin and weakened muscle in the lower lids that a chemical peel or a laser alone may not sufficiently be able to treat. It is commonly used on patients who have moderate to severe extra skin. This procedure rejuvenates the lower lids by removing puffiness and dark circles. It can also tighten the lower lid muscle and skin.

Fat Repositioning

Fat repositioning is a technique that Dr. Zoumalan performs on patients that have both excess lower lid fat pockets and hollowing along the infraorbital rim underneath the eyes. Fat repositioning allows the patient to have a more natural looking appearance while preserving their volume during surgery. Fat repositioning can help to prevent hollowing after lower lid blepharoplasty. However, some patients may still have hollowing even after lower lid fat repositioning. In that case, Dr. Zoumalan will recommend that you may need additional procedures such as injectable fillers to better improve the hollowing following surgery. The injectable fillers that are used around the eyelid area are composed of hyaluronic acid and can be done in the office using a topical numbing cream.


Dark circles can often result from hollowing or volume loss along the lower eyelid area. The hollowing results in a concavity or a “trough” which appears like a dark area due to the shadowing effect. Filling of the lid-cheek area and the mid-face with some form of dermal filler is typically what is done to treat hyperpigmentation. Fillers injected to the lower lids can help improve the volume deficiency people often get with aging, and also improve dark circles.

Fillers can be synthetic such as hyaluronic acid agents or acquired from the patients themselves using fat grafting taken from their abdominal fat. Dr. Zoumalan will consider fat grafting in certain cases of severe volume loss; otherwise he prefers using hyaluronic acid fillers since they are very predictable, reversible, and performed in the office.

Chemical Peels/Laser resurfacing

Patients who have thin skin may benefit from a combination of treatments if they also have volume loss or excess fat pockets. Thin skin, at times, can allow the underlying blood vessels around the fat pockets to be translucent which causes darkening of the skin. In such cases, a combination of treatments such as a chemical peel or laser resurfacing with a blepharoplasty surgery may be recommended to remove the excess fat pockets. Chemical peels and laser treatments can help tighten the lower lid skin and increase collagen formation. Patients with mild skin pigments changes or light wrinkles often do well with such resurfacing procedures.

Choosing the Right Surgeon

Correcting dark circles and bags under the eyes requires great attention to detail and a high skill level from an experienced oculoplastic surgeon. Dr. Christopher Zoumalan exclusively specializes in cosmetic eyelid surgery. He is one of a handful of plastic surgeons that has received subspecialty training as a board-certified Oculoplastic Surgeon. Schedule a consultation today so we can help you achieve the younger eyes you deserve.

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