What are under eye bags?
Under-eye bags, characterised by puffiness, swelling, and dark circles, can affect people of any age but are more common as one gets older.
Eye bags are usually just a cosmetic concern and not an indication of any underlying medical problem. Fortunately, both DIY home remedies and in-clinic treatments are available to address the issue.
What causes under eye bags?
As we age, the muscle and tissue surrounding the eyes can wither, causing the fat that is supporting the area to move forward or sink down. This can result in puffy and swollen lower eyelids, as well as creating or worsening tear troughs (creases area between the inside corner of the eye to the upper cheek).
Additionally, fluid retention under the eyes can cause further skin stretching and puffiness. Common causes of fluid accumulation include high-sodium foods, allergies, lack of sleep, and smoking. Swelling under the eyes can also cast a dark shadow.
The appearance of noticeable eye bags can be genetic and may start at an early age. For example, some patients report that hereditary eye bags have made them appear tired since just 10 years old. The prominence of eye bags may also fluctuate on a daily basis, a trend that becomes more apparent over time.
Melon Tip: Eyelid aesthetics experts, can diagnose whether lower eyelid puffiness is due to under-eye bags or "festoons". Festoons are often mistaken for eye bags, but they are located below the eyelid and include the upper cheek area. There are various types of festoons and remedies will depend on the underlying cause. Treatment options range from over-the-counter medications to in-clinic injections, laser resurfacing, or surgery.
How to get rid of under eye bags
Both surgical and non-surgical procedures are available to address eye bags, treatment options will depend on the severity and cause. It is important to consult an experienced doctor to determine the best course of action for you.
Under-eye bags can be removed or reduced most effectively with the following treatments, (recommended by doctors and patients).
Injectable fillers to treat eye bags
Dermal fillers can be used to conceal under-eye shape abnormalities by adding volume. The effects can be seen immediately but are not permanent, with results typically lasting around a year.
Fillers do not directly reduce puffiness, instead, they fill the empty space below the fat pads to create a seamless transition from the lower eyelid to the cheek. Fillers also help minimise the appearance of shadows under the eyes.
Injectable fillers are not officially approved for eye bag use by the TGA, but they are often used off-label. It's important to find a practitioner who is well-versed in facial anatomy and has experience performing under-eye filler injections.
A blunt-tipped cannula is typically utilised for this fast in-clinic procedure to minimise bruising and discomfort.
If you are unwilling to undergo surgery, fillers can provide a noticeable improvement, but they will not completely conceal under-eye bags.
Dissolvable dermal fillers, which are thinner in consistency, are well-suited for use in the delicate eye area. They have a lower risk of causing lumps or bumps and do not retain as much moisture, which reduces the likelihood of excessive swelling. An added benefit of dissolvable fillers is that if you are unsatisfied with the results or experience complications, they can be dissolved using an enzyme.
Bruising is a common side effect, which generally subsides within 2 weeks and can be concealed with makeup. Ice packs applied before and after the injections can also help reduce bruising. Lastly, there is a chance of a bluish discolouration known as the Tyndall effect and in rare cases, blindness can occur if the filler is mistakenly injected into a blood vessel.
Learn more about dermal fillers.
Laser resurfacing for under eye bags
By using laser technology, laser resurfacing can help to remove the outermost layers of the skin, revealing renewed and revitalised skin underneath. This process is effective in addressing wrinkles in the under-eye area and can also help firm the skin.
Ablative lasers, which remove the top layers of the skin, produce the most dramatic results but also have a longer recovery period. On the other hand, non-ablative lasers have a faster recovery time but may require multiple treatments to achieve optimal results.
Both types of laser treatments provoke the skin's natural healing response which leads to an increase in collagen production. This new collagen helps to tighten the skin, improving the general appearance of the under-eye area.
Eyelid Surgery to fix eye bags
Lower blepharoplasty, also known as lower eyelid surgery, is a highly successful method for removing eye bags permanently. The procedure addresses excess skin and fat, resulting in a firmer and more refined form beneath the eye.
It is typically done using local anesthesia and the incisions are made just under the lash line to make scars inconspicuous. Recovery time for this surgery is normally 1 to 2 weeks.
An incision on the inside of the eyelid, a scarless technique, can be used to repurpose fat into the tear troughs instead of removing it. This approach is more beneficial in the long run as we naturally lose facial fat as we age. Withdrawing too much fat from the face can lead to a hollowed-out appearance in the lower eyelids while repositioning the fat maintains the structural integrity of the lower lid.
This transconjunctival approach does not involve stitches, has a recovery period of around a week, and is used to target only pockets of fat. To address additional issues such as loose skin and wrinkles, other procedures such as laser therapy, chemical peels or micro-needling can be used in conjunction.
To address both excess fat and excess skin, many surgeons are now opting for a dual-incision method. This method involves addressing the fat through a transconjunctival incision and then removing the skin through a lash-line incision. This technique is becoming increasingly popular as it preserves the vital supporting structures of the lower eyelid located between the skin and fat, resulting in fewer complications.
Lower blepharoplasty is a powerful technique to reduce under-eye bags, but it is not without risks. In some cases, a surgery that is too aggressive can lead to further sagging of the lower lids, resulting in an overall worse appearance, and more discomfort. To minimise the risk of potential complications, it is essential to choose a board-certified surgeon with many blepharoplasties under their belt.
Learn more about eyelid surgery (blepharoplasty).
Facial fat transfer to fill in under eye bags
Facial fat transfer is a popular alternative to dermal fillers that can provide a more natural and longer-lasting outcome. This surgical procedure is minimally invasive, performed in under an hour, is done with local anesthesia and only causes minor discomfort and post-operative swelling.
The technique involves the use of small microinjections to gradually build soft tissue and stimulate new blood vessels in the grafted area. Normally, 50 to 60% of the transferred fat survives the procedure and should remain permanently.
However, one limitation of fat transfer is that it can be less consistent than fillers. Poor execution of the procedure may lead to unevenness that can be challenging to resolve in thin under-eye skin.
Fat transfer is a two-phase process that starts by extracting surplus fat from the body with liposuction. It is important that the fat gathered is of good quality, and that this quality is maintained during the transfer. The second phase of the procedure is the precise injection of fat into the target area. This can be difficult for even the most experienced surgeons, as the results of eye-bag fat grafting are hard to predict.
Before committing to a long-term solution, it may be wise to try temporary fillers first to ensure that you are happy with the effects If you decide to proceed with a more permanent correction, it is important to choose a highly experienced and skilled provider for the fat transfer procedure. When performed correctly, it can be an excellent option, but it is not uncommon to see patients seeking removal of previously grafted fat in the under-eye area.
How to get rid of eye bags without surgery?
Although eye creams cannot perform miracles, it's important to not underestimate their ability to reduce puffiness. The skin around the eyes is the thinnest on the face, making it more susceptible to creasing. To combat under-eye bags, it is recommended to use a formula that includes ingredients such as retinol and peptides, as these can increase collagen production and strengthen the skin.
Caffeine is a common ingredient in eye creams as it helps to constrict blood vessels which decrease puffiness and redness.
Dark circles can also be treated with skincare products that contain ingredients such as vitamin C, arbutin, kojic acid, licorice, and niacinamide (vitamin B3), which can help to brighten the under-eye area.
You don't have to break the bank to find an effective eye cream. Experts suggest checking out your local pharmacy as there is little difference between a $30 and $300 eye cream, apart from fragrance, packaging, and marketing.
Additionally, there are several home remedies that can immediately reduce or de-puff eye bags. One effective method is to apply ice packs or chilled cucumber slices to the eye area. The low temperature can constrict blood vessels and decrease fluid leakage, minimising puffiness. Applying cool, wet caffeinated tea bags also has a similar anti-inflammatory effect.
Can you use hemorrhoid cream for eye bag puffiness?
Hemorrhoid cream may contain phenylephrine a substance that can constrict blood vessels. However, it's crucial to apply it with precision as it can cause severe inflammation if it comes into contact with your eyes.