Can bags under eyes be corrected without surgery?

Is there a recommendation to help alleviate bags under eyes without surgery?

I would say the answer to this is yes, usually. But it depends on what the problem is causing these bags under eyes! First do a little analysis on yourself. Does the bag sit right under the eye and next to the lash line? Is the bag lower down (almost on the cheek bone) and fluctuates a lot up and down depending on sleep, alcohol, salt etc? Do you have a very obvious under eye groove (tear trough extension) that makes you look tired? Is the under eye skin also crinkley and saggy? It helps to try and figure this out. Then you can know the best solution.


Causes and treatments for bags under eyes:

  1. Fat pads right under the lower lash line: These are usually inherited and if large, need surgery to reposition them. They will usually get slowly smaller with age.
  2.  Obvious tear trough: This will make the under eye area look baggy when it’s really an optical illusion created by the shadow where the fat pad of the eye area and the cheek area have separated creating a trough. I hope that makes sense. These can be treated with fillers (read my eye treatment resource here for more info). Experts only please!! It looks great when done well and often lasts about a year. Two treatments may be needed to fully correct in the beginning.
  3. Puffiness right at the top of the cheek bone: This is usually caused by loss of elasticity in the skin above the problem and sometimes fat pads. Nonsurgical tightening of the skin with a CO2 laser will work for this unless it’s severe (then you’ll need surgery). Expect to need 1-3 treatments of the CO2 laser above 2-3 months apart depending on how bad this is. I hate to be the buzz-kill, but avoiding sugar, white, flour, salt and alcohol really helps reduce puffiness here in the interim.
  4. Puffiness under the eye: This can be due to too much Botox/Dysport around the eyes. If you’re not sure, stop the Botox for 4-6 months and see if this improves.
  5. Under eye crinkles. If not too bad, try the combination of an eyelid Thermage followed by an eyelid Fraxel. The Thermage tightens the skin a bit and the Fraxel helps with the crinkles.

If you have uncontrolled allergies, please see an allergist. Allergies contribute to bags under eyes and puffiness!

One thing you can do to help prevent them, is use an eye cream morning and night to prevent crinkling and premature aging around the eyes. In my opinion, none of the creams work well to fix these, but they help for prevention. Here’s a link to good ones I recommend.

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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