Dark circles under the eyes can be treated by dermal fillers, chemical peels or carboxytherapy. Dark circles caused by pigment can be removed by stimulating the lower skin layers with a laser. In addition, cosmetic lower eyelid surgery can involve skin incisions directly below the lash line or an incision on the inside of the eyelid. This is called a transconjunctival approach and it allows for access to the eyelid without visible incisions. Eyelid incisions typically are closed with sutures or skin glue. It is an excellent option for patients whose dark circles are caused by symptoms of aging and not by temporary lifestyle choices like lack of sleep.