That's a great question that I get asked quite frequently and from young patients like yourself too. Here are some reversible factors that can lead to puffy, swollen eye bags.
1. One of the common causes include an excessive accumulation of fluids, called edema, in surrounding skin tissue which can be due to overconsumption of salt, which causes fluid retention. A simple change in your diet can reduce that swelling.
2. A bad night’s sleep can also lead to puffy eyes in the morning as your body will release cortisol from your adrenal glands, and that changes the salt balance in the body leading to water retention.
3. Allergies can also cause inflammation and swelling. If you are prone to allergic rhinitis or allergic conjunctivitis, getting this treated may help with those puffy eye bags.
Those are some common causes of puffy eyes that may be reversible with simple change in diet or lifestyle or treatment with medication. Some patient mistake eye bags for dark eye circles. You can read more about dark eye circles here : "What is the most effective treatment for dark eye circles?"
Some of my patients have tried all of the above and still have stubborn puffy eye bags. If that is so, then those puffy bags are the appearance of the lower eyelid fat pads. As we age and lose facial volume, the bags are revealed. In the past, the treatment of these eyebags was removal via trans-conjunctival lower eyelid surgery (from the inside of the eyelid) hence leaving no scar on the outside.
In the last decade, the philosophy of lower eyelids has evolved and we now try to preserve the fat of the lower eyelid. The use of dermal fillers or fat graft can help to camouflage the presence of the eye bag by blending it with the upper cheek, restoring a youthful appearance. The injection of fillers is relatively painless and takes about 15 minutes. However, the injection around the eyes is very delicate and requires advance training. In the proper hands, this treatment is very safe and effective.
Structural fat grafting (using Coleman technique), is another treatment modality that is rapidly gaining popularity as fat is a permanent and natural filler from your own body. However, it is permanent once the fat engrafts so you want to be sure you are seeking treatment with an experienced doctor.
Some patients have very prominent and large eyebags and these will often have to be removed with the use of surgery as mentioned above. The fat is rarely removed but rather we shift the fat to the cheek after releasing the tear trough ligament, killing 2 birds with one stone - disrupting the appearance of the eye bag whilst still preserving the precious fat in the periorbital region.
If you desire surgery, speak to a board-certified and experience plastic surgeon in your area before you commit to any further surgery. Make no compromises! I hope I answered your questions and all the best!
Dr. Terence Goh
Plastic Surgeon
