I’ve got dark circles and hollowness under my eyes. Can fat transfer be used to improve this and is it safe?

There are several possible causes for dark circles around the eyes. Some are medical conditions, like allergies and/or thyroid disorders. Identification of these potential medical conditions and, if present, treatment can improve upon the appearance of the dark circles around the eyes. Dark circles can also be due to pigmentation of the skin, blood vessels beneath the skin, and hollowness. Pigmentation of skin is best treated with skin care products and skin resurfacing techniques, like chemical peels or laser resurfacing. Blood vessels beneath the lower eyelid skin are difficult to treat, but may improve with laser treatments. Hollowness of the lower lids is due to fat in the lower lids becoming more prominent, thus creating a bulge or fullness AND cheek tissues losing volume and descending. One option for treatment of this condition is augmentation. While fat transfer is a potential option for volumizing the cheek, fat transfer to the very thin skin of the lower lid may result in contour irregularities. Filler augmentation of the hollowness with a hyaluronic acid filler is a nice option and, if a contour irregularity occurs, it is easily treated with injection of the enzyme, hyaluronidase, which breaks down the product. A surgical option for this condition is lower lid blepharoplasty with fat repositioning/transposition. In this surgery, I keep the fat of the lower lid attached to its blood supply and then reposition the fat from areas of fullness to areas of hollowness, thus providing a more youthful contour between the lower eyelid and cheek.