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The eyes have it, post 19: dark under eye circles in a beautiful, young woman. This energetic and funny patient wanted her lower lids to help her look as spunky as she feels. This is actually quite a difficult problem to deal with and can have many different causes from baseline skin pigmentation, show through of the underlying musculature and vasculature and volume loss causing shadowing. Darker skin at baseline can also exacerbate this problem and make treatment challenging. Here you see the results of some subtle volumization with filler and neuromodulation with something like Botox, Dysport or Xeomin. This was all performed via cannula to give minimal downtime and swelling. 

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