Dark Circles Surgery: What Are Your Options and How Efficient Are They?

• Dark circles are a result of either hyperpigmentation or visible veins beneath the eyes.
• There are a wide range of professional treatments available for dark circles.
• Noninvasive and minimally invasive options provide short-term solutions lasting several months.
• Surgical procedures can provide permanent results.

There are many over-the-counter (OTC) and at-home solutions available to address the appearance of dark circles under the eyes.

Dark circles are often simply due to lack of sleep or dehydration. However, if you experience chronic dark circles regardless of your lifestyle habits, you may want to consider professional treatment.

These procedures range from noninvasive peels to plastic surgery, all serving to rejuvenate the skin and give you a more well-rested, healthy appearance.

Can You Get Rid of Dark Circles Permanently with Surgery?

Dark circles under the eyes are caused by either hyperpigmentation of the skin or the visibility of the veins beneath it.

Dark brown circles develop when melanin, the pigment that gives skin its color, collects in the skin. These deposits occur as a result of genetics, overexposure to sunlight, infections or allergies. 

Brown circles are best treated with minimally or noninvasive treatments that resurface the skin to restore natural skin color; surgery cannot eliminate them.

Dark purple circles become visible when the delicate, thin skin below the eyes reveals the color of underlying veins. These dark circles can be treated with dermal fillers to restore volume loss, and various skin resurfacing treatments to improve skin quality.

Sometimes dark circles are exacerbated by excess skin and fat around the eye. When that is the case, surgery is a more permanent solution.

Surgical Procedures for Dark Circles

Several cosmetic surgeries are available to correct dark circles. While their applicability is somewhat limited, they can provide permanent solutions for those suffering from chronic dark circles.

Blepharoplasty

Eyelid surgery, known as blepharoplasty, is a procedure in which excess fat or loose skin is removed from the eye area. The primary function of a blepharoplasty is to eliminate under-eye bags and drooping upper eyelids, however it can also effectively reduce the appearance of dark under-eye circles.

“A blepharoplasty procedure can be performed on the upper or lower eyelid,” says Dr. Rafi Fredman, MD, a plastic surgeon with a focus on facial rejuvenation and reconstruction procedures. “In this procedure, an incision can be made either on the outer or inward-facing side of the eyelid. Extra eyelid fat is removed or redistributed and any extra skin is removed. This procedure is usually performed with local anesthetic.”

This surgery typically takes from 1–3 three hours to perform. It does not have a lengthy recovery period and leaves little to no scarring.

Average cost: approximately $3,000.

Tear trough implants

While only appropriate for some people, tear trough implants are another surgical option to treat dark circles.

Tear troughs are the depressions that join the lower eyelid and cheek, so called because tears flow into them when they’re more pronounced. 

Silicone implants can be used to correct very deep tear troughs, a condition known as tear trough deformity. These implants are an appropriate solution only for people with exceptionally deep tear troughs; they cannot, however, correct hyperpigmentation.

After administering general anesthesia, the surgeon inserts the implant through a small incision inside the lower eyelid. Recovery from initial bruising and swelling takes several days, with final results seen after several weeks. 

Average cost: between $2,000 and $4,000

Minimally Invasive Procedures

Minimally invasive treatments produce dramatic and fast results. They range from laser-based technologies, which stimulate the body’s natural functions to improve skin quality, to more involved techniques, such as dermal fillers.

Nonablative lasers

Nonablative lasers leave the skin intact and function by stimulating collagen growth and tightening the targeted area of skin. The vast majority of laser-based treatments in this category include intense pulsed light devices, Q-switched lasers and pulsed dye lasers.

However, not all lasers are appropriate for people with darker skin. Consult with a specialist as to which lasers will work best with your skin type.

Dermal fillers

Dermal fillers are used to correct dark circles resulting from volume loss or thinning skin beneath the eyes. This procedure consists of injecting a natural compound (usually hyaluronic acid) beneath the skin to prevent the underlying blood vessels from appearing.

“Dark circles commonly appear because of loss of volume under the eyes,” explains Dr. Fredman. “Adding volume with filler can reduce dark circles in these circumstances. Dark circles appearing solely due to pigment changes in the skin will not improve with filler.”

Injectable fillers are a temporary solution that can smooth out the under-eye area and the tear trough for 6–9 months before the compound is naturally absorbed into the body. Fillers can also eliminate fine lines for an overall rejuvenation of the area below the eyes.

Fat transfers

As an alternative to hyaluronic acid fillers, fat transfers use fat from your own body. While they are more expensive than regular dermal fillers, they last much longer.

“A benefit of fat transfers is that their effects are permanent, while fillers are temporary,” says Dr. Fredman. “Fat transfers also have the benefit of providing a very natural look. They are preferable for people who want a longer-lasting solution or do not want to use a dermal filler.”

As with commercially produced fillers, fat transfers can reduce dark circles and soften the appearance of herniated fat, meaning fat that has moved from the under-eye area down to the cheeks due to aging and gravity.

Noninvasive Treatments

These procedures for dark circles remove the topmost layer of skin to improve the look of dark under-eye circles.

Ablative laser treatment

While nonablative lasers penetrate the skin to directly target deeper tissues, ablative lasers function by removing surface layers of skin. This serves to eliminate damaged and deteriorated areas of skin tissue, and encourages cell growth and renewal.

Ablative laser procedures can be used to treat a variety of skin conditions, and are appropriate for addressing dark circles caused by irregularities in pigmentation, loose skin and volume loss.

“Ablative lasers are commonly used for the lower eyelid,” says Dr. Fredman. “They build collagen, tighten skin, improve wrinkles in the eye region, and can be a suitable nonsurgical option for treating dark circles.

CO2 lasers and erbium lasers are commonly used for this procedure. CO2 lasers were the gold standard for skin resurfacing for many years and are still widely used. However, erbium lasers are gaining in popularity, as they enable a shorter recovery time with less heat damage to the skin.

Chemical peels

Widely available in a variety of strengths and combinations, chemical peels enhance the overall health of the treated area by deeply exfoliating the skin. They can be used to treat dark circles caused by discoloration from both sun exposure and pigmentary disorders. The administering professional can customize the treatment’s effects by varying the depth of penetration.

Chemical peels do, however, carry a risk of harmful side effects for some patients. “Chemical peels should not be used on patients with a history of abnormal scarring on the face, such as keloids or hypertrophic scars, active skin infections, certain skin diseases or active kidney or liver disease,” says Dr. Fredman. “Extra care must be taken when treating people with darker skin tones, due to the risk of skin pigmentation changes.”

Dr. Fredman advises that, depending on the type of peel used, chemical peels may also carry a risk of side effects for those who are pregnant, lactating or who have recently undergone oral isotretinoin therapy.

Summary of Procedures for Dark Circles

Procedure	Causes It Can Treat	Pros	Cons
Blepharoplasty	Excess fat, loose skin	Permanent	Expensive
Tear trough implants	Tear trough deformity	Long-lasting solution for tear trough deformity	Invasive; long recovery; limited applicability
Ablative lasers	Hyperpigmentation, low collagen, loose skin	Versatile, noninvasive	Can cause scabbing, irritate skin
Nonablative lasers	Stimulate collagen, correct pigmentation	Versatile, noninvasive	Not suited to all skin types; may temporarily worsen hyperpigmentation
Chemical peels	Hyperpigmentation	Customizable; no downtime	Causes temporary light sensitivity
Dermal fillers	Volume loss causing visible veins	No downtime	Only lasts 6–9 months
Fat transfers	Volume loss; herniated fat	Longer-lasting than dermal fillers	Expensive

Takeaway

There is a variety of treatments and at-home remedies to address dark circles under the eyes if you experience them only on occasion. 

For more severe dark circles, noninvasive and minimally invasive techniques along with surgical procedures can offer rapid and long-lasting results.

Consult with a dermatologist or a plastic surgeon to determine which procedure or procedures would be best suited for treating your dark circles.