Question: I have been thinking about filling in my dark under-eye circles for a long time with Radiesse and I am finally ready to do it. However, I am worried that I will have to keep doing it forever. I do not want that. After using Radiesse a while, is it possible that my dark circles will just disappear forever?
Answer: First of all, I would strongly recommend that you do not fill dark under-eye circles with Radiesse. I feel that there is too high of a risk of creating irregularities and bumpiness with Radiesse, and Radiesse cannot be reversed. I therefore recommend hyaluronic acid products like Juvederm Ultra or Restylane as these products are much softer and gel-like and more forgiving in this otherwise rather difficult area to treat. With that being said, these are temporary fillers, whether it be Radiesse or the hyaluronic acid products, and these will need to be performed again in the future though, in the lower eyelid area, these typically last approximately a year.
I would have to examine you to determine the reason for the dark under-eye circles but most patients have these dark under-eye circles due to shadows from bulging fat in the lower eyelid. The fat can be addressed through a lower eyelid blepharoplasty and, in certain patients, this fat can actually be moved into the hollow or groove below the fullness to fill this in and create a more aesthetic cheek-lid junction. Some patients have vascularity and/or pigmentation that is contributing to the dark circles under their eyes. The vascularity is extremely difficult to treat and, in most patients, I just recommend that they cover it with some makeup. The pigmentation, however, can be treated relatively easy with the use of broadband light or intense pulsed light.
Skin creams can also be used to help get rid of some of the abnormal pigmentation but, if the dark circles are due to shadows secondary to the fatty herniation of the lower eyelids, then a long-term solution to your concern would be a lower eyelid blepharoplasty.