What Causes Puffy Eyes, Bags under Eyes and Dark Circles?

Our eyes are our most important facial feature! Unfortunately our eyes are the first area of the face to show signs of aging. Fine lines and crow's feet can start to show in our late 20's and early 30's. Puffy eyes, bags under eyes and dark circles can also appear early.

Aging changes in the skin cause the eyelid skin to lose elasticity and sag. As the eyelid begins to loosen, normal fat that lies beneath the eyeball pushes forward against the lower eyelid and creates a bulge or eye bag or puffy eye. A shadow forms beneath the protruding puffy eyelid and creates a dark circle beneath the lower eyelid.

We inherit our eyelid structure, so if one or both parents have bags under the eyes, then you are prone to develop eye bags.

Prevention

There are many things that make the lower eyelids swell and which accelerate aging changes. Sun exposure is the worst. Wear your sun block! High salt intake (salted popcorn, Chinese food, etc.) causes the fat beneath the lower eyelid to absorb fluid and swell, making puffiness worse. An unhealthy lifestyle that includes tobacco and excess alcohol intake definitely contributes to eye bags and eyelid wrinkles.

Problems with Older Eyelid Rejuvenation Techniques

Very new, improved and safer eyelid rejuvenation techniques have been developed in the past few years to overcome several problems with traditional blepharoplasty, the plastic surgery technique for eyelid rejuvenation. Newer plastic surgery techniques preserve and reposition eyelid fat rather than removing fat. Older techniques that removed fat often created a hollow eye appearance.

Older blepharoplasty techniques also used an incision below the lower eyelashes made with a scalpel. This technique often led to a weakening of the lower eyelid which changed the beautiful lower eyelid shape. This problem is called an ectropion and creates a sad eyed look or hound dog eye.

Modern Techniques for Removal of Puffy Eyes, Bags under Eyes, and Dark Circles

• Transconjunctival Blepharoplasty-Today, rather than making a visible incision on the outside of the eyelid, surgeons make a tiny incision on the inside pink portion of the lower eyelid-the conjunctiva. By avoiding the outside incision the support of the lower eyelid is not damaged and the eyelid shape is not changed.

• Fat Repositioning-Instead of removing the fat from the eyelid, the fat is repositioned down lower, on the top of the cheek bone. This maneuver plumps the dark circle and adds youthful fullness to the upper cheek.

• Laser Blepharoplasty-Instead of a scalpel I use a laser to make the tiny incision in the conjunctiva of the lower eyelid. The laser is very precise and accurate and seals blood vessels as the incision is made. There is less bruising with the laser technique.

Act Now

Eyelid rejuvenation techniques work well when you are younger and when puffy eyes, bags under eyes and dark circles are just starting to show. As we grow older and eyelid aging progresses, more permanent changes such as loose skin and wrinkles are harder to correct and may require more complex surgery including skin removal and eyelid tightening called a canthopexy.

Find an Expert

Eyelid plastic surgery is an art. I always recommend consulting two board certified plastic surgeons before you decide. Ask the doctor if eyelids are his/her specialty and how many they have done. Ask to speak to patients who have had eyelid surgery done by the doctor.

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