LAM FACIAL PLASTICS

Dr Lam,
My question is regarding under eye circles. I am 31, and have had HORRIBLE under eye circles my entire life. I am always being asked tons of questions about how bad they look. Questions I hear all the time are, "Did someone hit you? Were you in a car accident? When was the last time you got some sleep? Are you on drugs? Are you sick? Do you have the flu?" The list goes on and on. I am very fair skinned which does not help matters any. Are there any laser or plastic facial methods available for this condition? I am willing to do just about anything for these. As I get older, they get worse. Tons of makeup does not even cover it anymore. Any advice or suggestions would be appreciated.
Thanks!
JF

obviously under eye circles is a very broad topic. you could be talking about thin skin with muscle showing through, veins that are prominent and discoloring the skin, or simply hollowness. the only thing that i know that i can manage successfully is the hollowness either with ongoing temporary fillers or more permanently (minus the effects of aging) with fat transfer. as far as muscle or vein discolored skin, there is not much help for this condition. for that you can ask your dermatologist but i have very few known tricks in my bag for that type of eye circle.
best,
sml

Hi Dr. Lam,

I wonder about why a fat transfer doesn't help to hide muscle and/or viens that are showing. Doesn't the fat sit between the muscle and skin? In most of the before and afters that I have seen, the most striking improvement is often in the under eye area - it looks much less shadowed, with less dark areas. Of course, this is the elimination of shadows but I can only imagine that it is also a plumbing effect of the skin that hides whatever lies beneath

Thanks.

no, do NOT put the fat between the muscle and skin. i have had 2 surgeons (both very experienced) who first told me they were getting "success" with this area only to show me disasters shortly thereafter. what are the observed problems with this superficial a placement: lumpiness and also yellow discoloration of the fat being visible under the thin skin. i go deep on bone. that is safe. yes, the dark circles that are resulting from volume loss respond well to fat. other types of dark circles do not.
best,
sml

Oh, wow that is surprising. I guess I figured you put it where it "used to be."

Makes sense, though. Thanks.

no, safety always first!