From the Division of Facial Plastic Reconstructive Surgery, Department of Otolaryngology–Head & Neck Surgery, University of Miami College of Medicine, Miami, Fla. Dr Epstein has a private practice, Miami.
Despite the frequency with which it occurs, little has been written in the scientific literature on the treatment of infraorbital dark circles. I have developed a technique that simultaneously treats the 2 contributing causes of these circles: hyperpigmentation of skin and pseudoherniation of orbital fat. The technique involves simultaneous transconjunctival blepharoplasty and deep-depth phenol chemical peel. Successful outcomes have been obtained in patients with Fitzpatrick classification skin types 1 to 5, with a low incidence of complications. Adequate preoperative counseling regarding prolonged erythema and careful postoperative monitoring with, if necessary, medical intervention are essential if both surgeon and patient are to be satisfied with the outcomes.
Epstein JS. Management of Infraorbital Dark CirclesA Significant Cosmetic Concern. Arch Facial Plast Surg. 1999;1(4):303-307. doi: