Non Surgical Treatments

PRASAD Cosmetic Surgery offers some of the most advanced laser procedures available today to treat various skin disorders such as:

  • Varicose veins
  • Spider veins
  • Anti-Aging treatments for deep skin rejuvenation
  • Treatment for removal of rosacea
  • Hand rejuvenation for treating protruding hand veins, brown pigment and thin skin

Dr. Amiya Prasad Talks About Non Surgical Treatment for Dark Circles

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You asked:


How Do I Get Rid of Dark Under Eye Circles?

I am 35 year old white male with dark under eye circles. I tried 2 treatments unsuccessfully: 1) laser by dermatologist, 2) 8 weeks of teamine. The laser treatment left me with white dots in tear trough area. I saw a small improvement with Teamine but not much. The doctor also recommended arnica Montana and I may try that next. What is the best way to obtain even tone and texture (no more dots or discoloration) in the under eye region? Also, while I research treatments, what is the best method of concealment?

Dr. Amiya Prasad:

Thank you for your question!

Dealing with dark circles under the eyes is a huge industry. If you go into any drugstore or one of these skin care retail outlets, just ask where the under eye circle treatments are and you will be overwhelmed. And there are a variety of reasons for dark circles under the eyes and in my practice, people come to me a lot for this problem. So let’s learn a little bit about what is responsible for dark circles under the eyes.

Let’s start first with genetics and heredity. That’s the most common issue because a certain amount of pigmentation is going to be a part of this area if that runs in your family.

Next, we have the skin quality itself and that’s where the opportunity is. Skin quality, becoming creepy, thin related to exposures I should say, like sun exposure, smoking and stress. All of these things can affect the skin quality and can age the skin. And so, when we think about eyelid skin, realize that the eyelid skin is the thinnest skin in the body. It’s half a millimeter in thickness and anything that breaks down the collagen in the skin will cause the dark circles, the fine lines to occur.

The other thing to be aware of has to with allergies. When you have chronic allergies, in medicine, we refer to that as allergic shiners or almost a bluish quality under the eyes. Another thing that we should mention is when a person’s skin is very light, they have light eyes or light hair. Then practically their eyelid skin is almost transparent and your able to see through the bluish quality or the reddish color of the muscle underneath.

So in my practice, one of the things we’ve had very good results with and again, when we talk about very good results, we don’t mean complete 100% amazing improvement but significant improvement is something called platelet-rich plasma. Now, platelet-rich plasma is a very interesting method that we employ that’s basically transferring technology that’s used in orthopedics. Now more and more athletes are going for injections of platelet-rich plasma for knees. People know about basketball players, football players who are getting these injections. Well, in cosmetics, we’ve been using platelet-rich plasma for a variety of things and what I’ve been using it is for under eye circles and I’ve been consistently getting improvement. In the concept of platelet-rich plasma, there’s a couple of things. One is, it stimulates collagen as in the healing process and two, it stimulates blood flow and blood supply to the skin. So that results in the skin quality having a little bit more luster. So these are the things that injectable cannot do. And using platelet-rich plasma is a very straight forward and in our practice, the patient comes in the office, we draw blood like we’re drawing a routine blood supply and then we spin it and we isolate the platelets and we do the injections. So that’s one option.

Other options that we employ in our practice include fractional C02 laser. Essentially, any laser that takes off the top laser skin can allow tightening and new collagen to occur can improve the appearance of dark circles. Otherwise, when you talk about concealment, you’re looking for some type of camouflage which is more in the make-up category or tinted, moisturizer to look less dark. Some of these work very well but again when you apply this type of method, then you’ll have to consider where it goes from looking like it blends well or where it is obviously make-up. So you have a lot of choices there.

In our practice, I developed a particular cream that I called eye rescue that at the superficial level of the skin, it does improve the plumpness. One of the things about skin under the eyes that is very dry, it can look very wrinkled and it can look very dark. So what I came up with is a moisturizer that has a slight tint to it and I had my patients apply it to the skin daily. It basically improves the superficial aspect of the skin. It’s almost like waxing a car just smoothing out a lot of the irregularities. It also has some active ingredients. But when you really want to build the quality of the skin, you want to work a more systemic way or at a more aggressive way. So, platelet-rich plasma is our first go-to treatment for dark circles under the eyes.

So, I hope that was helpful and thank you for your question.

Dr. Amiya Prasad Talks About Non Surgical Treatments for Facial Wrinkles

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When I Smile or Squint, The Thin Skin Under My Eyes Puffs Up into Wrinkly Bags. What Are my Options?

Thank you for your question. You’re asking what to do about wrinkly skin that becomes very wrinkly and puffy when you smile. Now this is a very common issue in my practice, especially people with lighter skin. You know, the eyelid skin is the thinnest skin in the body and that means that the skin being half millimeter in thickness is easily affected by a lot of factors including sun exposure, being one of the biggest ones, smoking, even hydration can really affect the delicate skin under the eyes. So based on the photos you submitted, what I notice to you was that even if your skin is relaxed, when your face is relaxed, there are lines that are there. Now those lines in our field, we refer to those as static lines. And then, when you smile, those wrinkles and lines become more accentuated, and those are referred to as dynamic lines.

One of the biggest mistakes people has made, and as a specialist in the eye area, I have seen so many people who went to a doctor to have the skin removed with the misperception that there was excess skin. And so when they removed the skin, because when they smiled it bunched up so much, if their face was relaxed, their eyelid pulled down and it’s a problem called lower eyelid retraction. So I’m not going to advise you to have cosmetic eyelid surgery necessarily. Essentially, the approach that I would consider is to treat the skin so that it improves in skin quality.

Now how do we do that? This is a half millimeter thick skin so there’s only so much you can do. But in my practice, I routinely use lasers, such as my fractional CO2 laser and I combine it with the use of platelet- rich plasma. Now this is a very leading edge procedure where we actually draw your own blood and we spin it and concentrate the factors that are responsible for healing. And what that does is, it stimulates the body’s own collagen and it basically improves the skin texture as well as stimulating blood supply, and so the skin becomes healthier. So, if you were to have platelet- rich plasma and the laser, that’s one aspect of this.

Now, years ago, I actually made a point to recommend combining these treatments where we try to smooth out the skin with Botox or Dysport. And the reason is we want to reduce the activity of muscles that will cost the wrinkling to occur during that time when the skin is healing. So, I think that combining something like Botox or Dysport to reduce the activity of the muscle and then using a procedure or a combination of procedures to smooth out the skin, I think will help. I don’t think that it will completely eliminate it because as long as you’re moving and smiling, you’re going to have some of that bunching. But I think this will be a good way to help prevent things from getting worse and improve the current situation. I hope that was helpful and thank you for your question.


But it’s not just the procedures themselves that make these treatments at PRASAD Cosmetic Surgery unique. It’s the experience and expertise of our staff and in the way we treat our patients. Whether it’s a procedure to remove ropy varicose veins, wrinkles, age spots or any other treatment,  PRASAD Cosmetic Surgery creates and manages your individualized treatment plan ensuring the highest quality care and the most effective results.

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