LAM FACIAL PLASTICS

Hi
Like you said you can use botox to held up the skin to prevent aging or reverse aging. But what can be done to the dark circle under the eyes? Will it be safe to use botox all around the eye? Is mid 20s too early for botox? thanks dr lam.

Botox is not too early in the mid-20s, especially for fairer skinned individuals who may have extensive previous sun damage. The study that was done on two identical twins was done over 13 years with them starting in their late 20s. However, for darker complected races without much sun damage, Botox in the 20s may be overkill that early. Only a consultation with a physician (with integrity) can help you make that assessment. Botox is safe around the eyes but not to manage dark circles. It is for WRINKLES and to prevent them.

As far as filling dark circles, I get that question a lot. Obviously, you could be having severe allergies leading to that problem, necessitating a medical intervention and not surgical. You could have had significant sun damage in your teenage years leading to more soft tissue and fat loss at an early age. You may have prominent veins simply because you were born that way (difficult to fix). You may be looking too closely and too often at the mirror at an imperfection that most people (not everyone but most) don't even notice. You may have thin skin with your orbicularis oculi muscle being visible (not really fixable). Bottom line, you would need an in-person consultation to make a proper assessment.

I've heard from some patients that dark circles (the ones from veins not from melanin) sometimes could be hidden with fat grafting under the eyes. What is your experience with that Dr. Lam?

Possibly. I really do fat grafting for hollowness. It would be an oversell to sell fat grafting as a treatment for veins. Also, a few physicians who have the courage (or aggressiveness) place the fat very superficially to cover the veins. After speaking with them, they have lived to regret this (and so have the patients) for years. It is too dangerous to go superficial. That at least is my opinion. I am not a risk taker.
best,
sml