Whether you deal with them daily or just didn’t get enough sleep last night, no one likes dealing with dark undereye circles. Now, people are trying to fend them off with a new plastic surgery procedure called “Carboxytherapy” or “Carboxy.”
With Carboxy, doctors inject the soft tissue underneath the eyes with carbon dioxide, which reportedly increases blood flow in your capillaries and changes dark circles back to your normal skin tone. According to the website for Precision Aesthetics, a practice that claims it was one of the first to perform the procedure in the U.S., “minute amounts” of carbon dioxide are injected just below the surface of the skin and the “relatively painless” procedure is completed in five minutes. “A series of two to six treatments spaced one week apart is all that is required to achieve a great result,” the Precision Aesthetics website says.
Injecting anything into the tissue under your eyes sounds iffy, but carbon dioxide? Is that safe?
Yes, Marc Malek, M.D., a board-certified plastic surgeon, tells SELF. “If performed correctly and carefully, I think Carboxy can be a good option,” he says. Carbon dioxide is naturally produced in our bodies, he explains, so it’s not necessarily bad to have a doctor inject it into your skin.
But Gary Goldenberg, M.D., medical director of the Dermatology Faculty Practice at the Icahn School of Medicine at Mount Sinai, isn’t convinced. “The claim is that this procedure induces collagen repair and improves elasticity and circulation,” he tells SELF. While Carboxy is approved by the FDA as a form of mesotherapy (a multiple-injection procedure in which vitamins or drugs are inserted under the eyes), Goldenberg says large-scale studies have not been able to prove that it’s as safe and effective as using fillers or laser treatments for dark undereye circles. “Mesotherapy has been talked about for everything for decades, but results have been disappointing,” he says.
While Malek thinks Carboxy is safe, he doesn’t necessarily suggest that his patients try it. “I recommend undereye creams to my patients that contain vitamins A, C, and E,” he says. “Collagen production is then increased and skin becomes less transparent, making the undereye circles less visible.”
Goldenberg also recommends using a different treatment: a combination of fillers like Restylane, Juvederm, or Belotero and possibly pairing it with a laser treatment such as Fraxel (or just doing laser treatment alone, if injectables aren’t your thing).
Mitchell Chasin, M.D., founder of Reflections Center for Skin & Body, agrees. He tells SELF that he recommends fat transfers or dermal fillers paired with laser therapy as well. "These two treatments will thicken and tighten the skin, improve skin texture and tone, lift the skin up off the vessels which cast a purplish hue, and smooth out any contour irregularities," he says.
But treatment ultimately depends on the cause of your undereye circles, Goldenberg says. “Often the problem is a combination of skin pigmentation and shadow effect due to loss of volume in the tear trough,” he says. If they really bother you, an evaluation with your doctor will be able to help tell you more. No matter what, keep in mind that like cellulite, undereye circles are often a normal part of life, not something wrong with you that desperately needs "fixing."
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