Dark circles can occur due to shadows created from volume loss (from changes in eyelid skin, subcutaneous fat, deep fat & bony eye socket) and skin pigmentation (which can be hereditary, vascular, post inflammatory or mixed).

Tear trough fillers visibly improve the darkness arising from the shadows of volume loss, however skin pigmentation of ethnic dark circles stays and is very difficult to correct completetly.  With proper skin care pigmentation can resolve slowly.

We love to use Restylane, RHA 2 dermal filler and Belotero balance for this delicate area of the eye. Under-correction is in this area is better than over-correction so the results look more natural.

Protecting the eyes with

good SPF and treating the pigmentation with topical eye serums like Alastin A-luminate can gradually improve the dark circles in 6-12 months.

One of the commonest reasons patients request to see us is to have “tear trough fillers” to look “fresher” or “less tired”

PRF or platelet rich fibrin is another injectable treatment to improve dark circles and build collagen naturally in that area. PRF contains platelets, white blood cells, fibrin and stem cells. Platelets excrete growth factors slowly that increase the collagen production, tighten skin and rejuvenate texture of the skin.

We recommend 2-3 sessions spaced 3-4 months apart.

What is indirect treatment of the tear trough? By your mid-30s the anterior cheek starts to deflate, which makes the lower eyelid appear hollow, as it drops into the cheek. Subtle mid-face volume restoration improves the sunken appearance of the eyes!

At Brandywine med spa we like to incorporate combination treatments. Our multi-modal approach using energy based treatments (Vivace and Exilis) along with injectables are ideal for patients who do not want to undergo a face lift and are seeking natural visible results, with minimal downtime..

Vivace is the newest generation of radio frequency microneedling that stimulates the natural production of collagen and is shown to be effective in alleviating facial wrinkles, fine lines, and tightening and toning the area.

We combine the treatment with the newest breakthrough in numbing cream, treatment serum and recovery care to create an optimal patient experience.

Exilis Ultra delivers radiofrequency and ultrasound energy to precisely target, tighten and tone the skin.

Everyone is different, but the collagen you make is your own and continues accelerated production over three months. Most patients undergo 2 to 4 treatments of Exilis, scheduled 7 to 10 days apart. It takes about 15-30 minutes to do the procedure.

Both these treatments have minimal to no downtime. Most people go out within hours after the treatment with no make up at all.

The combination of a dermal filler to improve hollowness under the eyes along with some skin tightening treatments helps to rejuvenate this area.