Dark eye circles are a common concern among many of my patients, and sometimes they can be confused with eye bags.
Eye bags appear as swelling/ puffiness under the eyes. These are more common as we age, as the muscles and skin that normally support the lower eyelid weaken. Fats that surround the eyeball can then bulge through the weakened overlying structures and cause the lower eyelids to appear swollen and puffy. With an overhanging swellling, a shadow is cast underneath the swelling, causing the appearance of darkness at the lower eyelids. In my practice, I commonly see eye bags in patients in their late 40s onwards. AGNES is a radiofrequency device that can be used to melt some of the protruded fats in this area.
However, many of my younger patients also do have the problem of darkening of the lower eyelid skin. Many of them, however, do not have eyebags. The causes of dark eye circles in them are varied:
1) Excessive pigmentation, either due to congenital or environmental causes. Post-inflammatory hyperpigmentation of the lower eyelid skin is not uncommon in those with atopy/ allergies. Excessive sun exposure and intake of certain drugs can cause such pigmentation as well.
2) Thin, translucent lower eyelid skin causes the underlying muscles and its prominent blood vessels to show through, resulting in a dark purplish appearance.
3) Shadowing due to tear trough - a depression centered over the inner side of the lower bony socket. Loss of underlying fat and thinning of skin over the bony eye socket confers hollowness in the appearance of a dark curvilinear line.
Based on your photos, I see that your lower eyelid and cheek bone structure appears slightly deficient. I do not see much protrusion of fats in your lower eye lid, thus eyebags may not be the correct diagnosis in your case. You may have had slightly recessed maxilla (anterior cheeks) to begin with, thus worsening the appearance of the tear trough over the years. My personal treatment approach would be to first provide my support to your anterior cheeks. This can be achieved by fillers injected in the deep layers of the cheeks, thus giving a good foundation for the lower eyelid area. If there is still any residual depression in the lower eyelid (tear trough), a superficially placed filler can further improve the results.
Lighting and angle definitely affects the way a photo appears, and as such, to have a clear understanding of the causes of your dark eye circles, a face-to-face consultation with a doctor would be beneficial. The best approach would be to determine the cause of the dark eye circles and then formulate a treatment plan from there.
