A common reason for dark under-eye circles is the tear trough deformity. The tear trough deformity is a depression under the eyes which is often mistakenly perceived as just skin discoloration. In reality, the dark color of the circles is often greatly exaggerated by a pronounced tear trough under the eye. The tear trough will deflect light, thereby creating a shadow and an apparent increase of under eye circles and discoloration.
The nature of the tear trough deformity is very complex and often has multiple factors such as genetics, aging skin and unique anatomy of the area under the eye. Until recently, plastic surgeons have had limited options in improving tear trough deformity. Surgical options involved major surgical interventions with long down-time and potential side effects. These were among the main reasons why most patients had to settle for living with dark circles under the eyes, giving them a chronically tired appearance.