Bags under the eyes can make you look tired even when you are well rested. Some people have them from their twenties because of their genes; for others they appear gradually with age. The cause matters, because it determines which treatment will actually help.
What causes under-eye bags?
- Fat prolapse: fat that cushions the eye sits behind a thin membrane (the orbital septum). As this weakens, the fat bulges forward to form a permanent bag.
- Loss of volume in the cheek and tear trough creates a hollow that makes the bag above it look bigger.
- Skin laxity: thin eyelid skin loses elasticity and wrinkles.
- Fluid: puffiness that is worse in the morning, after salty food, alcohol, poor sleep or allergies usually comes and goes.
- Genetics: prominent fat pads often run in families.
When to see a doctor first
Swelling that appears suddenly, affects one eye, is red, itchy or painful, or comes with other symptoms should be checked by your GP, as it can be caused by allergy, infection, thyroid eye disease or kidney problems.
Non-surgical options
Good sleep, reducing salt and alcohol, and treating allergies can help fluid-related puffiness. Tear trough filler can smooth the hollow beneath a small bag, but it can make a true fat bag look worse or cause swelling if used in the wrong patient.
Lower blepharoplasty
Lower eyelid surgery removes or repositions the bulging fat and smooths the lid–cheek junction. It can be done through an incision just below the lashes, which also allows a little skin to be removed, or from inside the eyelid (transconjunctival) with no visible scar when there is no excess skin. The result for fat bags is usually long-lasting.
Recovery
Bruising and swelling settle over about two weeks, and most people are comfortable going out after 10–14 days. Risks include dry eyes, changes to the shape of the lower lid, asymmetry and, rarely, bleeding behind the eye that can affect vision, which is why lower eyelid surgery should be performed by an experienced surgeon.
Frequently Asked Questions
Can creams get rid of eye bags?
Creams can reduce mild puffiness temporarily but cannot remove fat bags.
Are eye bags genetic?
Often yes. Many people inherit prominent lower eyelid fat pads.
Is lower blepharoplasty permanent?
Removing or repositioning fat gives a long-lasting result, although the skin continues to age.
How much does lower blepharoplasty cost?
Lower blepharoplasty with Mr Nassab starts from £7,500. See the blepharoplasty cost guide for details.
