In this month's Plastic Surgery Practice Magazine, Dr. Kotlus defines the "tear trough", a groove under the eyes that appears as a dark circle.  He approaches the tear trough with a combination of therapies, laser resurfacing (seen above), injectable fillers, and possible eyelid lifting surgery. Because everyone has different anatomy, a customized treatment plan is needed in most cases. 

Fillers for the tear trough are most commonly composed of hyaluronic acid, a soft gel.  When used under the eyelid, the results can last longer than a year. There may be limited swelling or bruising after the procedure, but downtime is often minimal. 

Laser resurfacing can have downtime lasting for days, but the outstanding improvement in fine lines and skin texture are often worth the recovery investment.