Eyebag / Dark Circle Treatment


The eyelid is one of the first places on the face that shows signs of aging. The thin eyelid skin, the underlying eyelid muscle and the fat around the eye are some of the many factors that lead to an aged appearance. As we age the eyelid skin becomes wrinkled and thinned allowing the dark muscle under the skin to be more evident (dark circles).  The purple hue often seen on lower lids is the blood product within the muscle, as the skin can be as thin as 0.3mm thick in the lower lid. The eyelid fat also moves forward and downward to produce a heavy, swollen appearing lower eyelid “bag.” The bag then produces a shadow leading to even more evident dark circles and a prominent tear trough.

There are many ways to combat lower eyelid bags and dark circles depending on what factors are causing this appearance. Some patients may benefit from volume augmentation with a dermal filler such as Restylane to create a smoother eyelid cheek junction.  If more volume is needed, an implant may be a better choice. Others may need improvement in the texture and quality of the skin on the lower eyelid that can be achieved by laser resurfacing, chemical peels or creams. Not all patients will need surgery since some patients will improve with noninvasive techniques. There is no one right treatment for every lower lid and each patient’s treatment must be individualized. At The Zatezalo Group we have a variety of ways to correct the appearance of the lower eyelid bags and dark circles.

If you are a surgical candidate, Dr. Zatezalo may offer you a lower lid blepharoplasty surgery. Again, there are many ways to perform a lower lid blepharoplasty.

Traditionally both skin and fat were removed from the lower lid to produce a smooth and a less prominent lower eyelid. However, with time the lid may appear hollow and dark if excessive fat is removed. A more novel approach to the lower lid calls for repositioning of the fat over the cheekbone and into the tear trough. This technique augments areas deficient in volume to produce a rejuvenated appearance and a smoother transition from the eyelid to the cheek.  A titrated fat reposition may also be more appropriate if there is a large amount of orbital fat and a shallow tear trough.

Lowe lid fat reposition blepharoplasty is performed under IV sedation (by a board certified anesthesiologist) in the OR at The Zatezalo Group. The incision is made inside of the lower lid to access the fat pads which will be repositioned. After the fat is addressed, any loose skin on the lower lid is removed. There are several ways to remove the skin on the lower eyelid which Dr. Zatezalo will discuss with you. You will have a fuller more rejuvenated appearance and a smoother lid cheek junction after the fat is repositioned. After blepharoplasty surgery, most patients will have bruising and swelling since the eyelid tissue has many blood vessels. There are several ways to minimize swelling and bruising which can be addressed.

Correcting lower eyelid dark circles and bags require attention to detail and a high level of skill which is the premise for consulting with an oculoplastic surgeon with extensive experience in this area. Lower eyelid blepharoplasty is an outpatient procedure that is regularly performed at The Zatezalo Group.