Your eyes are a prominent feature of your face. Under eye bags, dark circles, or puffy skin can all make you seem as if you’re overly tired, stressed, or even older than you really are. Sometimes, allergies or your diet may cause under eye bags even when you get plenty of sleep.

If you’ve ever looked in the mirror after a sleepless night, you might see dark circles accentuating the eyes. But those dark circles really may be shadows cast by eyelids that are puffy and protruding. They may even be hollows under the eyes that can occur as a natural part of aging.

No matter what causes them, what is the answer to unsightly under eye bags? Is surgery always the right approach? Why do some people seem to have such saggy eye wrinkles, anyway? This article will help you understand what you can do about under eye bags and whether surgery is always the right answer to remove them.

What Causes Under Eye Bags?

What Causes Under Eye Bags?Puffiness and dark circles under your eyes can be caused by several factors: 

  • Aging
  • Alcohol consumption
  • Allergies
  • Genetics
  • Lack of sleep
  • Medical conditions 
  • Smoking
  • Too much salt in the diet

Having deep-set eyes can also accentuate the puffy or dark circles, and it could be a facial feature that simply runs in your family. Allergies, like hay fever, can cause inflammation and congestion that exacerbate the under eye bags. Treatment of the allergies and avoiding rubbing the eyes can sometimes eliminate the signs of your suffering and improve your under eye bags.

Consumption of a high salt diet can increase inflammation and swelling in the body. This can make your eyes appear puffier. Another lifestyle choice—smoking—can cause not only under the eye bags but also some serious eye conditions that can be a major health concern. Smoking causes the collagen in the skin to break down faster, thinning the skin and making the blood vessels more visible.

The most common cause of saggy, puffiness under the eyes is the natural aging process. As you age, the skin and tissues around the eyes gradually loosen, causing wrinkles and bulging. That’s why you are more likely to have worse under eye bags than when you were younger. To recapture a more healthy and youthful appearance, many people elect to have eyelid surgery to reverse these changes.

Can You Eliminate Under Eye Bags Without Surgery?

While they won’t be as effective as surgery, there are some home remedies that can lessen the appearance of dark circles and puffiness under the eyes. For example:

  • Treat your allergy symptoms 
  • Avoid rubbing your eyes
  • Get more rest
  • Use creams with caffeine, which work as a vasoconstrictor to tighten blood vessels under the eyes
  • Lay a cool compress or chilled tea bag under the eyes for a few minutes each morning while sitting upright
  • Avoid drinking fluids before bedtime and cut down on the salt in your diet to lessen fluid retention
  • Sleep with your head slightly elevated to help fluid drain from around your eyes as you sleep
  • Stop smoking

When these remedies don’t work, it’s time to see your ophthalmologist, who can talk with you about other options.

How Do Doctors Fix Under Eye Bags?

Your doctor can improve the look of your eyes by smoothing the skin around them. Nonsurgical options include:

  • Chemical peels to renew skin
  • Radio-frequency or laser treatments to resurface and tighten the skin
  • Facial fillers to revolumize the area around the eyes

However, in order to fix the bulging of the under eyes, your ophthalmologist can perform a cosmetic eyelid surgery known as blepharoplasty to remove or reposition the fat pockets around the eyes. Let’s look at each of these aesthetic treatments and procedures to determine what could be right for you.

Chemical Peels

Chemical peels are a type of intense exfoliation process to remove the top layer of skin cells. Chemical peels can be used under the eye to stimulate new, tighter skin to form. This is especially true if the under eye skin is thin and loose. Chemical peels are an effective non-invasive method for temporarily improving texture, tone and pigmentation. 

Radio-frequency Treatments

Radio-frequency (RF) Skin Lifting can be used under the eyes to regenerate collagen. When there is fluid and swelling, or loose underlying skin, applying heat from a radio-frequency device works to tighten and lift sagging skin. While this procedure is used frequently to eliminate fine lines, wrinkles and scars, it can also help with the loose skin under your eyes. 

Laser Resurfacing

Laser skin resurfacing is an office-based procedure that can help renew skin, rid blemishes, laxity and irregularities in texture. The laser penetrates skin to a specific depth and area, inducing collagen production and renewal of the skin surface. The result is firmer, tighter, more youthful skin.  

Facial Fillers

Facial fillers (also called ‘dermal fillers’ or simply ‘fillers’) can also be used to reduce the appearance of under eye bags by adding volume to areas that may appear deflated. Dermal fillers such as Restylane or Juvederm, are made of a material known as hyaluronic acid. It is a substance found naturally in our skin, joints, and other connective tissues that helps promote collagen and hydration of tissues. Fillers can be a great tool for non-surgical facial enhancement, adding volume back to the hollowed-out areas around the eyes, flattened cheekbones and temples. 


Blepharoplasty for the lower eyelids is a cosmetic surgery to remove the extra skin and fat from around the eyes. When the lower lids are bulging forward, this is the most effective treatment to fix them. The surgery will be customized to your needs and anatomy and the results of this procedure can be dramatically effective.

Worried About Your Under Eye Bags?

You don’t have to worry about your under the eye bags when you’re a patient at Ocala Eye. We know that every patient is different, and we personalize our approach using these types of treatments to give you the results you deserve. 

The oculoplastics team under the leadership of Sarah Kim, D.O., M.P.H., at Ocala Eye has performed countless blepharoplasties to improve the lives of our patients. If you’re interested in talking with our team about this procedure, please don’t hesitate to contact us. Talk with our experienced team to find out how we can help.

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