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Infraorbital dark circles refer to the darkness of lower eyelids and can be a significant cosmetic
problem for the people of any age and sex. Although the general concern for dark circles is
increasing, little has been published about the treatment of dark circles in the scientific literature. Dark
circles are not a single disease but combination of causative symptoms. We classified patients to five
groups according to patients’ symptoms; bulging of infraorbital fat (Ia), sunken lower eyelids (Ib),
depression or groove on midface (Ic), thin translucent skin (IIa), and excessive pigmentation (IIb).
We reviewed medical records and photographs of patients retrospectively. The classification of
patients and the treatment of the groups were evaluated. Problems of shape, especially bulging of
infraorbital fat was the main cause of dark circles in most patients (65.2%). The treatment of each
group included transconjunctival fat reposition or removal (Ia), single fat cell graft (Ib,IIa), microfat
graft (Ic), and various dermatologic therapies (IIb). We obtained better results when we did combination
of the treatments according to symptomatic groups.
(Archives of Aesthetic Plastic Surgery 17: 91, 2011)
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