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Under Eye Bags: Causes and Treatments

Karli Plunkett, DMSc, PA-C, LME

July 23, 2023

3 min read

Under-eye bags, medically known as periorbital puffiness, are a common cosmetic concern that can affect individuals of all ages. These bags or swellings are often associated with aging, lack of sleep, chronic stress, and genetics. Understanding the causes and available solutions, including non-surgical options like dermal fillers and surgical interventions like eyelid surgery, can help individuals make informed decisions about managing this condition.

Causes of Under Eye Bags

As we age, the tissues and muscles supporting our eyes weaken. The fat that ordinarily helps uphold the eyes can then shift into the lower eyelids, causing them to appear puffy. Simultaneously, the skin around the eyes loses elasticity, further contributing to the appearance of bags. Aging also leads to a redistribution and prolapse of fat, which can create a bulging effect under the eyes.

Solutions for Periorbital Puffiness

Dermal fillers, such as Restylane, are a popular non-surgical solution for under-eye bags. These fillers are gel-like substances that are injected beneath the skin. They work by filling in hollows, smoothing out contours, and improving facial symmetry.

Restylane, a hyaluronic acid-based filler, is often used to treat under-eye bags. Hyaluronic acid is a substance that our bodies naturally produce, and it plays a vital role in keeping our skin hydrated and volumized. When injected under the eyes, Restylane can help smooth out the appearance of bags by filling in the area, making the transition between the lower eyelid and cheek smoother.

The procedure is relatively quick, usually taking less than an hour, and the results can last for several months to a year. Side effects are typically mild and can include temporary swelling, redness, and bruising at the injection site.

For more severe cases of under-eye bags, eyelid surgery, also known as blepharoplasty, may be considered. This surgical procedure involves removing or repositioning excess tissue, including skin and fat, from the upper and lower eyelids. The goal is to reduce bagginess and improve the contour of the eyelid.

Eyelid surgery can be performed on the upper lids, lower lids, or both. The procedure typically takes one to two hours and is usually done under local anesthesia combined with oral sedation. Recovery time varies but generally, patients can return to normal activities within two weeks.

While eyelid surgery can provide more permanent results than dermal fillers, it's important to note that it is a more invasive procedure with potential risks, including infection, bleeding, and changes in vision. Therefore, it's crucial to have a thorough discussion with a qualified healthcare provider to understand the potential benefits and risks.

Additional Considerations

Lifestyle factors can significantly impact the appearance of under-eye bags. For instance, a diet high in salt can cause your body to retain water, leading to puffiness. Similarly, smoking and excessive alcohol consumption can contribute to skin aging and exacerbate the appearance of under-eye bags. Therefore, adopting a healthy lifestyle, including a balanced diet, regular exercise, and avoiding harmful habits, can help manage this condition.

Certain medical conditions, such as thyroid disease, sinus infections, and allergies, can also lead to under-eye bags. If you notice persistent or worsening under-eye bags, it's important to consult with a healthcare provider to rule out any underlying medical conditions.

Choosing the right treatment for under-eye bags depends on the underlying cause, the severity of the condition, and individual preferences. While dermal fillers can offer a quick and less invasive solution, they are temporary and may not be suitable for more severe cases. On the other hand, eyelid surgery can provide more permanent results but comes with potential risks and a longer recovery period. Our Orlando med spa treats patients with dermal fillers for under eyes and refers out other patients for blepharophasty surgeries.

Dealing with under-eye bags involves understanding the causes, exploring various treatment options, and considering lifestyle changes and potential underlying health conditions. With the right approach, it's possible to effectively manage this condition and enhance your overall facial aesthetics.


Chronic Stress & Lack of Sleep

Sleep deprivation and chronic stress are significant contributors to under-eye bags. Lack of adequate sleep can cause the skin to become pale and dull, allowing dark tissues and blood vessels beneath the skin to become more visible. This can result in dark circles that may accompany the puffiness. Chronic stress can similarly affect the skin's appearance and exacerbate the look of bags under the eyes. Both conditions can also lead to fluid buildup beneath the eyes, adding to the swelling.


Genetics play a crucial role in the development of under-eye bags. Some individuals inherit the predisposition to have puffiness under the eyes. If your parents or grandparents have or had under-eye bags, you're more likely to develop them as well.

Injectable Dermal Fillers

Blepharoplasty Surgery

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