Blepharoplasty or Fillers for under-eye circles?
I am 50 years old and have some facial fat loss and sagging of the skin. Most significant are the dark circles under my eyes. I have slight drooping of the upper lid and deep glabellar lines. One consult recommended fillers for under the eye and in cheekbones and another recommended surgery (and said the fillers wouldn't eliminate the dark circles). Both said that Botox (or similar) could be done at the same time as either procedure. Any advice for me?? (Note: I am getting married in 7 weeks. Not expecting full results by then but, sure don't want to look obviously post-procedure!).
I will start with your conclusion. Seven weeks is too little time to schedule appropriate surgery and recovery when you're having a wedding (and my congratulations to you). At this point, injectable fillers and neuromodulators such as Botox would be useful for the right indications. Botox for glabellar creases is an excellent initial step and does not need to be done during a surgery procedure. Proper use of Botox beneath the lateral eyebrow can give a slight elevation of the lateral brow. Under-eye grooves may be an indication for hyaluronic fillers such as Restylane which can be used with care, but not if the primary problem is protruding fat pads. If experienced plastic surgeons recommend blepharoplasty, then you will probably want to schedule it sometime after your wedding. I usually recommend lower lid surgery heal well before HA filler is placed, but other surgeons may recommend another approach. Best wishes.
There are several possible causes for dark circles under the eyes so a definitive answer would require a physical exam. Shadows from contour depressions in the tear trough can be eliminated with fillers or blepharoplasty. Venous congestion or muscle edema may respond to laser treatments. Surgical correction may require a month or two to see final results so your timeline may be more amenable to nonsurgical refinement for now with more definitive correction down the road.