Dark circles under the eyes can have multiple causes and so a consultation is essential. Circles can be caused by skin discoloration from venous congestions usually due to allergy or pigmentation. Usually however dark circles are caused by shadowing from a fatty pocket that has protruded forward, from loss of cheek volume over the superior cheek or more commonly a combination of both.
The treatment for dark circled related to skin discoloration is targeted at the cause. More commonly the treatment is to take care of the shadowing. In younger patients the treatment may consist of filling the hollowing of the upper cheek with a filler such as Restylane. This is a simple office procedure that takes 30 minutes and usually lasts 9-12 months. In more significant cases cause is corrected by blepharoplasty and/or fat transfer. Usually there is a slight puffiness in the fat pads of the lower eyelids. This fat is removed and tightened by performing an incision inside the eyelid (transconjunctival). A fat transfer is performed by harvesting fat from the lower body through a tiny incision and then placing it into the face through tiny punctures. This procedure builds the cheek up into the natural position of youth and hides the lower eyelid shadowing.
It is difficult to describe in words how effective these treatments are. Photos do them much more justice. Please take some time to look at our site, especially the before and after photos. I believe you will have a much better understanding.