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Dr. Zoumalan's Blog - News and Updates

Tired of Looking Tired? This Under-Eye Bag Treatment May Be What You’ve Needed

Posted On 09/09/2019 by Dr. Christopher Zoumalan

brown eye close up on background.

If you feel you look “tired” or “sad” even though you’re not, it may be time for a change. Under-eye hollowing caused by volume loss under the eyes can age you unnecessarily. Many people have not heard of tear trough hollowing, which is a common age-related finding seen in people. Either a part of the eyelid can be hollow such the tear trough area, or the entire lower eyelid area, termed infraorbital rim hollowing. When hollow, the undereye can cause shadows to fall under your eyes, giving you the appearance of dark circles. In cases where you truly have visible fat pockets, a minor lower eyelid blepharoplasty would be the better option, and not under eye fillers. Dr. Zoumalan successfully treats under-eye hollowing with fillers in the right patient. Tear trough fillers rejuvenate the face and improve the appearance of the eyelids.

Hyaluronic Acid Injections

Experts in eyelid fillers usually treat the eye area with hyaluronic acid injections such as Restylane. This technique’s goal is to plump the skin around the under-eye bags. It evens the bags with the surrounding skin, diminishing shadows and improving appearance. Cheeks do not appear “filled,” as the change is subtle.

Dr. Zoumalan is a skilled oculoplastic surgeon who routinely performs tear trough fillers. Watch Dr. Zoumalan explain his tear trough procedure in this video. To make an appointment or get answers to your questions regarding tear through fillers, contact Dr. Zoumalan today!

The Procedure

The treatment takes as little as 30 minutes and begins with a topical anesthetic. Patients return home as soon as the treatment is complete. Dr. Zoumalan uses a cannula rather than a needle to perform the injections. This leaves the patient with less risk of initial bruising than might otherwise be the case. It also makes the procedure more comfortable.

View before and after photos of Dr. Zoumalan’s patients.

Other Options


Blepharoplasty is a surgical option for patients with visible eye bags with or without hollowing. It is not the same as fillers, and a blepharoplasty is a procedure that Dr. Zoumalan routinely performs. It is a tried and true method for getting rid of under-eye bags with dark circles. It is suitable for more severe cases. Blepharoplasty is also a more permanent solution. During your consultation with Dr. Zoumalan, he will check for these things:

  • Excess fat on the lower lid
  • Volume loss along the lower lid and cheek area
  • Excess lower lid skin


All these issues can be successfully addressed with this lower eyelid surgery. View before and after photos and watch Dr. Zoumalan’s video on blepharoplasty.

During the procedure, Dr. Zoumalan will remove and reposition the prominent fat. He may also tighten the skin using various methods including a fractionated C02 laser, chemical peel, or microneedling. Blepharoplasty is often combined with a brow lift. The combination improves the appearance of the upper lid and forehead. These work in tandem with the lower lid improvements.

Dr. Zoumalan’s Natural Looking Blepharoplasty® surgery minimizes the chance of looking like you have had surgery. Dr. Zoumalan has perfected this technique over 10 years of practicing cosmetic eyelid surgery.

Non-Surgical Blepharoplasty

Non-surgical blepharoplasty is done without any cutting or trauma to the skin. It can address fine lines, wrinkles, and hollows in addition to under-eye bags and dark circles using injectable filler and/or botox. The treatment will vary with the patient’s concerns and condition. Dr. Zoumalan uses state-of-the-art technology to provide immediate results that only improve over time.

Dark Circle Treatment

Dark circles can be caused by various issues, including these:

  • Prominent lower eyelid fat pockets (bulging fat pockets, eye bags). Blepharoplasty is a good option for most patients with prominent lower eyelid fat pockets.
  • Hollowing or volume loss of the lower eyelid, which includes the tear trough area as well. Volume loss often occurs with age. Often the mid-face and cheek area also undergo volume loss. Injectable fillers are often great options.
  • Hyperpigmentation of the skin (which can be caused by certain medications or genetic predisposition). Skin brightening creams can often be helpful.
  • Thin skin allowing the underlying muscle and blood vessels to show.
  • Underlying allergies or rosacea.


[Source: https://www.drchristopherzoumalan.com/procedures/non-surgical-cosmetic-procedures/dark-circles-treatment/]

If you think you have any of the above conditions, contact Dr. Zoumalan for a consultation. He can determine the best course of treatment based on the underlying cause. These may include surgical and non-surgical options. Dr. Zoumalan may recommend fillers, surgery, skin brighteners, or even a visit to the allergy specialist.

Tear Trough Fillers Beverly Hills

Dr. Zoumalan is an oculoplastic surgeon exclusively practicing cosmetic eyelid surgery in Beverly Hills. He also specializes in injectable fillers around the eye area to improve dark circles and under-eye bags. Dr. Zoumalan regularly schedules consultations with out-of-town patients as well as Los Angeles area residents. He also offers virtual consultations here.

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