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Lower Eyelid Hollows & Dark Circles

Posted: 5:00 p.m. Friday, March 11, 2016

By Anita Mandal, M.D.
Question: I have dark circles under my eyes. They are very deep. I had Restylane once and then later Juvederm but they looked good initially but 6 months later half of the filler was gone even though it was supposed to last one year. Are there longer lasting options?

Answer: Firstly, it’s important to understand the difference between dark circles under the eyes and hollowing under the eyes. Dark circles are a dark discoloration of the lower eyelid skin itself, whereas hollowing refers to an actual loss of volume deep to the eyelid skin. Dark circles can be due to a change in pigment of the skin itself. In other cases, hollowing of the lower eyelid creates a shadow under the eyes, resulting in the illusion of a dark circle.

When the dark circle is a direct result of lower eyelid hollowing, correction of the hollowing typically improves the dark circle. Injectable fillers are the mainstay treatment for lower eyelid hollowing.

Restylane, Juvederm and Bellafill are all effective filler treatments. However, since Restylane and Juvederm are hyaluronic acid fillers which work by attracting water, there is an increased chance of puffiness. Additionally, these temporary fillers only last up to one year.
Bellafill, on the other hand, works by stimulating your own body’s collagen. When injected properly, Bellafill is less prone to puffiness under the eyes. Another key advantage is the 5 year duration of Bellafill.

While Bellafill has many significant benefits over temporary fillers, Bellafill treatments require a higher level of injector skill. Given Bellafill’s 5 year longevity, the injector must also have a greater understanding of facial anatomy and facial aesthetics. BellaDiamond physicians, which comprise the top 1% of Bellafill injectors in the country, have the advanced injector skill and perform a high volume of Bellafill.


25 Minutes: SculpSure, the new standard in permanent, non-invasive fat reduction with skin tightening: abdomen, flanks, back, hips, thighs, arms and chest.

40 Minutes: Infini RF, the Non-Surgical Facelift to Tighten sagging jowls and neck and soften wrinkles with no downtime.

90 Minutes: Bellafill, a filler that lasts five years. Dr. Mandal is a BellaDiamond physician which represents the top one percent of Bellafill injectors in the country.


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