Under-Eye Bags and Puffiness

Bags vs. puffiness

Morning puffiness that fades by lunch is usually fluid. True under-eye bags stay all day, no matter how much you sleep. They often come with dark shadows, a groove between the lower lid and cheek (called the tear trough), and thin, crinkly skin.

What causes them

The eye sits on cushions of fat held in place by a thin membrane. Over time that membrane weakens and the fat pushes forward, creating a bulge. Genetics play a big role, which is why lots of people have bags in their 20s and 30s. Salt, allergies, and poor sleep can make things look worse on a given day, but they don't cause true fat bags.

How Dr. Kim treats them

Dr. Kim performs lower blepharoplasty to remove or reposition the fat and smooth the transition from lid to cheek. When he can, he works through the inside of the lower lid, so there's no visible scar. If there's also extra skin, a tiny incision just below the lashes may be needed. Moving some of the fat into the tear trough can soften hollowness at the same time.

What about creams or filler?

Eye creams and cold compresses can help with temporary puffiness, and filler can camouflage mild hollows. True fat bags, though, generally need surgery for a lasting fix. Dr. Kim can tell you which category you fall into.