Hi and thank you for your question! While an in-person consultation is required to accurately determine the cause and best treatment options, dark circles under the eyes are usually caused by volume loss in the area under the eyes (and nearby toward the cheeks). Some patients might also have congestion and other issues that might compound the issues. In most patients, restoring volume under the eyes and toward the cheeks with fillers will lead to significant improvements. This is an advanced treatment and I highly recommend that you work with an experienced physician. I usually use Volbella for under the eyes and some Voluma for the cheeks for more natural look. PDO threads are not recommended for that area. I hope it helps and good luck!
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