Identify the cause.
Some dark circles are due to lifestyle (lack of sleep, too much caffeine, dehydration) and can be treated by making lifestyle changes.
Dark circles can also be caused by lose of or little volume in the cheek area (think the dark water of the deep sea vs. the light blue, shallow water of the Caribbean). These deeper areas can appear darker, and injecting filler into these areas can help to make the area shallower and lighter.
Pigmentation can also be the cause, and is often hereditary (Mediterranean and Middle Eastern patients, etc). For these patients, a light chemical peel, laser, or skin lightener can be effective.
Before and after of a patient of Dr. Shah’s-patient had upper and lower
blepharoplasty to reduce excess skin and fat, as well as botox.
Botox works to relax and smooth these areas
Heavy eyelids and puffiness can be treated with an upper blepharoplasty to remove the excess skin, fat or both, which cause this appearance.
Mild to moderate creepiness can be treated with a light chemical peel or in some cases botox or facial filler. More severe crepyness can be treated with a lower lid blepharoplasty, to move excess skin and tighten the area.
A lower lid blepharoplasty can be preformed to remove the excess fat that causes tis puffyness.