I am male, 55 years old and have a tired appearance most of the time. I believe it is due to permanent circles under my eyes. I have been looking into blepharoplasty. It looks like you remove the fat that is causing the circles. But wouldn’t that create loose skin? Do you remove some skin as well?
Dark circles under the eyes are only partially responsive to blepharoplasty surgery. The theory is that blood has "leaked" into the skin from the vasculature of the lower lids, primarily from the fat of the lower lids. Removing excess fat of the lower lid can help decrease the pigment of the lower lid, but, it may not completely clear the dark circles of the lower lid. Removing fat from the lower eyelid during blepharoplasty does not lead to loose skin. Having said that, the decision to remove skin at the time of your eyelid surgery because of excessive skin is a decision that is made preoperatively during your eyelid surgery consultation. In other words, if you need skin removed from your lower eyelid it would need to be removed with or without the removal of fat from your lower eyelid, and this is determined before eyelid surgery is started.