Sunken eyes are dark circles under eyes
Many people of all ages complain of dark circles under the eyes. The phrase "circles dark under the eyes "is used to describe a wide variety of different conditions, but the phrase dark circles under the eyes refers to an anatomical condition very specific to the lower eyelids that is easy to diagnose and easily correct modern techniques. However, many people complaining of circles dark under the eyes usually have a condition more appropriately termed "hollow eyes", which is a distinct anatomical condition very different circles dark under the eyes. Recognition eye syndrome "hole" is very important because the technique often used to treat "dark circles under eyes "not correct the hollow eye look and can actually make the 'hollow eye syndrome worse."
To clearly understand the difference between the different conditions of lower eyelid that many people have and seek treatment for it is important to understand the difference between "Dark Eyelid Color" Puffy lower eyelids, dark circles under the eyes, sunken eyes, and scallops:
Dark Eyelid Color The color of the lower eyelids is darker than the skin around the face in almost all human faces. This is a normal condition. The dark color of the lower eyelid is caused by the fact that the skin lower eyelid is very thin, so thin you can see through it. The eyelid muscle beneath the lower eyelid skin is purple, so the purple color of the muscle shows through the thin eyelid skin and lower eyelid looks darker than the surrounding skin. People often complain that the lower eyelid looks blue or purple. The fairer the skin, the skin thinner your lower eyelid and therefore the most obscure of the eyelids will appear. In many thin skinned individuals the veins running under the eyelid skin also show through the eyelid skin making the blue more intense. This is a condition normal and can not be treated. N laser, cream or surgery can correct this. The only solution is a concealer such as Dermablend or Cover mark.
Puffy lower eyelids As we age, many people noted that the lower eyelid skin is swollen or bulges outward. People often refer to this condition as "bags under the eyes." Bags under the eyes is caused by a combination of weakness and sagging of the lower eyelid skin and tissue caused by aging and changes, and protrusion of fat beneath the skin below the lower eyelid and the eyeball. Younger, healthy skin of the lower eyelid and tissues normally are taut and prevent fat from protruding, however with aging and skin laxity of the lower eyelid fat pushes forward and Excel, as a hernia. This condition, the bags under the eyes or swelling of the eyelids is technically called fatty orbital hernia, a hernia of the fat normally contained in the orbit or eye socket. The call plastic surgery lower lid blepharoplasty often includes removal or relocation of the protruding fat to lessen the appearance of bags under the eyes.
Dark circles under the eyes-The phrase dark circles under eyes refers to a dark depression below the lower eyelid which starts near the corner of the lower lid near the nose and extends along the cheek bone below the lower eyelid towards the ear. Technically this is called the naso-jugal fold, and in advanced stages of implementing the aging face in the tear trough deformity, a dark depression that runs out and down her cheek to the side of the face. The dark circle under the eye or naso-jugal fold is caused by a combination of factors. The most important thing is the skin of the dark circle is tethered tightly to the underlying bone of the eye socket, called the orbital rim, by a ligament called the arcus marginalis. Since skin dark circle is attached to the bones, it can not sag downward with the skin of lower eyelid and cheek with the aging of the skin and becomes lax. Thus skin lower lid, as it sags and is pushed forward and down by the protruding lower eyelid fat, puffs and falls over the dark circle and creates bound a dark shadow, the dark circle under the eye. The technique is only truly effective way to eliminate dark circles under the eyes is called arcus marginalis release with graft fat or position. During this procedure, the arcus marginalis is released from inside the lower eyelid and fat is placed beneath the dark circle to fill the dark circle and prevent the arcus marginalis to re-unite and re-create the dark circles under the eyes.
Hollow Eyes-Hollow Eye Syndrome describes a condition in which the entire lower eyelid appears "sunken in" and may be a natural or normal human condition or can be caused by trauma or as a result of an eyelid lower blepharoplasty during which too much fat has been eliminated lower eyelid. The main cause of the normal Hollow Eye Syndrome is a congenital absence of fat orbital below the eyeball that allows the lower eyelid skin and tissues to sink in, or the eye socket, also called the orbit, which is higher than normal and allows the lower eyelid, fat and tissue to sink in the hole because of the appearance of the eye. Abnormal Hollow Eye Syndrome occurs when excessive fat was removed during a blepharoplasty or when the bone beneath the eye has been broken, most commonly by a fist or baseball striking the eye, breaking the floor of the bony orbit and pushing the fat surrounding the eyeball through the break in the bone down into the sinus cavity below the bone. To correct the hollow eye syndrome, abnormal, and fat must be surgically replaced, or in the case of a fracture, the fat should be removed in the eye and the broken bone repaired.
In the case of normal Syndrome hollow of the eye, fat must be surgically replaced to correct the deficiency of fat and in some patients who have unusually large orbit due to a deficiency bone, the implant should be placed for bone deficiency orbital rim at the top of the cheekbone. This implant is called implant through a tear.
Garlands, Wreaths are the skin on the cheeks that are swollen just below the lower eyelids, at the top of the cheeks and below the circles dark under the eyes. Wreaths are skin of the cheeks, the lower eyelid skin, a very important distinction. Its main importance is to be recognized, and you should know that there are to be upgraded or removed during a blepharoplasty. In fact, a blepharoplasty during which puffy eyelid fat removed and lax lower eyelid skin tightens the scallops had been made more prominent and worse. Wreaths are little known and difficult to treat. Traditionally it was the only surgical method Direct excision and removal, however, this method is unacceptable scarring, visible on the cheeks. Sometimes a partial face lift called lifting cheek can improve festoons. Laser can improve them, but the skin color becomes lighter which makes this method risky. Recently newer skin hardening methods using infrared and radio frequency energy remain very promising.
In summary, the normal anatomical variations and changes the aging of the lower eyelids are very complex and often poorly understood by patients and many doctors. A correct and clear understanding of anatomy lower of the eyelids and cheeks and the effects of aging in these areas is essential for the aesthetic correction of lower eyelid is to be achieved. therapy Eyelid rejuvenation should use newer techniques that address the intraorbital fat, the arcus marginalis, and the scallops if pleasing aesthetic results want to achieve and serious deformity avoided. True Hollow Eye Syndrome requires fat volume replacement and placement of implants in some cases to correct the deficiency bone volume. It is important to distinguish the sunken eyes of dark circles under the eyes because their correction requires decidedly different reconstructive techniques. Recognition of the garlands is very important because the standard techniques of blepharoplasty eyelid rejuvenation Wreaths will most notable.
Brooke R. Seckel, MD, FACS
About the Author
Dr Brooke R. Seckel, Asst. Professor of Surgery at Harvard Medical School was recently named a Top Doctor in Boston by Boston Magazine. He is also listed as one of the Best Doctors in America. Dr Seckel is an internationally recognized expert in Plastic Surgery. Dr Seckel’s office is in Boston at 617-262-2208 or at http://saveyourface.com/
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Nov 8, 2008 
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