What are eyebags?

Eye bags are the lower eyelid fatty pads that are seen as the lower eyelids age. As we age and lose facial volume the cheek bone shrinks, eye bags appear as small puffy looking fat bulges under lower eyelids. 

 

What causes eyebags?

Eyebags primarily occur when the under-eye cheek bone that forms the floor of the eye socket shrinks as natural feature of age. Without a firm foundation of the bone, the skin and muscles around the eye region becomes loose and floppy. With continued shrinking of the bony platform the fat starts to bulge and without the firm skin and muscle to hold the fat back, the bulge becomes prominent.

 

What causes fluid and swelling under eyes?

Fluid puffiness under the eyes could be due to sleep issues, repeated nose and eye allergy and sinus problems or lower eyelid fat prolapse. A diet rich in salt can cause fluid buildup and make the eyes look puffy. For example, a late night out coupled with a high salt diet will make your eyes puffy in the morning.

 

What causes puffy eyes in the morning?

Puffy eyes in the morning is due to water retention due to a combination of lack of sleep and a consuming high salt diet. This should resolve spontaneously. If this persists you need to consult your doctor to exclude allergy and sinus issues.

 

Can lack of sleep cause eyebags?

Lack of sleep does not cause eyebags. It can cause puffy eyes due to the lack of lymphatic flow which is often mistaken for eyebags.

 

What foods cause eyebags?

A diet rich in salt can cause fluid retention and cause puffy looking eyes. This can exaggerate the appearance of eyebags. If you are allergic to certain foods, a swollen or puffy eye may be due to allergic response.

 

Are eyebags permanent?

Yes, eyebags are permanent and they gradually get bigger and more prominent with age. It is very common to see uneven or asymmetric eye bags between the two sides.

 

Eyebag Surgery (lower blepharoplasty) and other options?

Addressing eyebags is possible by surgery, non-surgical methods or a combination of both surgery and non-surgical methods. 
 
Eyebags treatment is precise, delicate requiring considerable technical skill. Your results will depend on the experience and expertise of the practitioner and hence it is imperative that you seek an experienced practitioner.
 

Do under eye or eyebags creams work?

Under eye or eye bag creams help to maintain skin health and as a maintenance option following surgery. Undereye creams cannot get rid of eyebags.

 

Under eye creams for dark circles

I am not aware of any one cream that has any particular advantages over another with regard to pigmentation improvement.  Dark under eyes or dark circles are partly caused due to the loss in volume that occurs with ageing. Using Dermal Fillers to restore lost volume is a logical first step that is an effective solution for you. 
 
Combining a prescription only medical grade skin care range would help the overall texture and health of the skin.

 

Home remedies for eyebags

The internet is full of home remedies for eyebags ranging from the sublime to the ridiculous. While some home remedies may work in certain individuals, they are not effective in most cases. They are more likely to work in very young people who have puffy eyes and not eyebags.

 

How to address eyebags without surgery

If the eyebags are small, then direct Radiofrequency treatment of the bags can shrink them. This can be combined with radiofrequency needling of the skin for a better impact.

 

How to address eyebags in men

Mild or small eyebags radiofrequency shrinking of the eye bags combined with radiofrequency tightening of the skin can help. In advanced cases of eyebags surgery is the best option.

 

Do anti-wrinkle treatments or Thermage work for under eye bags?

Neither anti-wrinkle injections nor Thermage will help. Bags are due to excess fat and skin that is made prominent by the shrinking of the facial bones immediately under the bulge. Depending upon anatomy and goals, filler or some form of lower lid blepharoplasty with fat redistribution will give best results.

 

Are there any new procedures for lower eyelid blepharoplasty surgery?

Some of the newer non-surgical treatment options can help treat mild cases of eyebags and dark circles. Not everyone will get a good result and a single option may not work often requiring a combination of options.
 
Dermal Filler will camouflage the hollows and reduce the appearance of dark circle. by restoring lost volume. Adding Radio Frequency skin tightening to blend the hollowness and tighten the skin can help optimize the result. There are Radiofrequency options to directly shrink the eyebags fat. 
 
Using PRP (Platelet Rich Plasma) to help build up collagen in the eyelid delicate skin can help reduce the static wrinkles. Integrating a prescription only medical grade skin care regime would help the overall skin health and help maintain the results.
 

How do I get rid of water retention under my eyes and puffy eyes?

Puffiness under the eyes could be due to sleep issues, allergy and sinus problems or lower eyelid fat prolapse. A diet rich in salt can cause fluid buildup and make the eyes look puffy. For example, a late night out coupled with a high salt diet will make your eyes puffy in the morning.

 

Eyebags and festoons are they different? what is the difference?

Eyebags and festoons are not one and the same. Eyebags occur directly under the eye, between the eye and the cheek bone. Festoons or malar bags occur ON the cheek bone. Frequently they are present at the same time and hence the confusion. 
 
Eyebags are caused by fat bulges as a result of the under-eye cheek bone shrinking as a part of the natural ageing process. As a result, the skin and muscles around the eye region becomes lax, loose and the fat starts to bulge.
 
Festoons too are a formed due to the ageing process of the cheek bone (not the part immediately under the eye) together with the laxity of the skin and muscle.
 

Malar bags and festoon – is lower eyelid blepharoplasty surgery a better choice than fillers?

Festoons in my opinion are the most difficult lower eyelid condition to treat. It is difficult because of many reasons. The anatomy is complex and not well understood, the results following any treatment be it dermal fillers, laser or surgery is unpredictable at best.
 
I have found that the best way to treat malar festoons is by surgery and using multiple techniques. Wide undermining of lower eyelid and cheek skin, release of tough ligaments like arcus marginalis, tear trough, orbito malar ligament, zygomatico facial ligament or midface ligament, fat transposition, canthopexy with midface lift and malar fat pad elevation, tightening of lower eyelid with a skin muscle flap followed by re-draping of skin.
 
Direct excision of festoons is an option that is reserved for very severe cases and for recurrence of festoons following surgery. The downside to this direct excision is a scar on the cheek that settles well.
 

Eye bag treatment options at age 25

At 25, it is reasonable to consider non-surgical treatment such as dermal fillers, skin tightening using Radiofrequency and RF needling. Sadly, creams don’t work, and I am not aware of any one cream that has a distinct advantage over another with regard to improving pigmentation or dark circles. 
 
Dermal Filler will camouflage the hollows and reduce the appearance of dark circle. Using Dermal Fillers to restore lost volume is a logical first step that is an effective solution for you. Dermal fillers need to be repeated once every 12 to 18 months. Adding RF skin tightening to blend the hollowness and tighten the skin can help optimize the result. Surgery is still an option, but with a plethora of non-surgical options, it is common practice to try non-surgical. Integrating a prescription only medical grade skin care regime would help the overall skin health and help maintain the results.

 

Eye bag treatment options at age 35

Removal of minimal fat and repositioning fat would provide a good result and is best done through a cut in the inside of the eyelid and not on the skin (transconjunctival blepharoplasty). This is a procedure where the fat pockets are sculpted behind the eyelid. The results look natural with no outside incision. It is critical that your surgeon be very conservative with fat removal because you could appear hollowed out if too much is taken. It is better to surgically under-treat than over-treat your problem. Depending on how hollow the cheek bone is, you may need to add volume to 'build up' your deficient eye socket rim. It can be done with a cheek implant, dermal fillers or fat transfer.
 
A maintenance treatment with anti-wrinkle injections will minimize the activity of the muscle and keep the wrinkles under control. A medical grade skin care regime will help maintain skin health and prolong your results from surgery.

Eye bag treatment options at age 55

Generally speaking, at 55 you may have loose skin, eyebags, tear trough deformity and deep midface lines with loss of contours of the cheek.
 
Transcutaneous lower lid blepharoplasty will be the best option that will allow removal of excess eyelid skin, removal of fat bags, tightening the muscle, redistribution of bulging fat and a midface lift.
 
A maintenance treatment with anti-wrinkle injections and top up dermal fillers will keep the wrinkles under control. A medical grade skin care regime will help maintain skin health and prolong your results from surgery.
 
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OUR PROCESS 

You will generally see Dr Somia 3 times before your surgery.   If you prefer one of these consultations can be held via telehealth.    Two consultations are required by law before a date for surgery is scheduled.   This is to allow you plenty of time to ask questions and feel comfortable about the procedure.   Your third consultation will assist us to prepare you for your surgery (ie paperwork, pre-operative testing). 

 

PROCEDURE DETAILS 

The surgery takes approximately  1.5 hours to 2.5 hours depending on the procedure recommended and requires an overnight stay in hospital.   Our fees include specialist plastic surgeon, specialist anaesthetist, fully accredited hospital theatre, accommodation and 6 months aftercare.    A formal estimate will be provided after you have discussed your goals and what is possible to achieve them with Dr Somia.  

 

RECOVERY 

Each patient recovers at a different rate and anothers recovery should not be compared with yours.

Generally, initial recovery from swelling and bruising is approximately 3-4 weeks.   A return to normal activities can usually be expected after 6 weeks.   Full results can be expected 3-6 months after.  

You can return to work when you feel well and if your employer has lighter duties for you and will allow you to take time to rest and move around.  

Most patients take 2-3 weeks off work if they work in an office context.   Patients working outdoors or in a physical capacity may need to take up to 6 weeks off work whilst they recover.   Talk to us about your specific occupation and surgery.   

You can drive when the anaesthetic has worn off, your vision is clear, and you are pain free getting in and out of the care and whilst performing an emergency stop.   You should check your vehicle insurance policy for their requirements in this situation.  

 

RISKS 

All surgery carries risks. When travelling overseas on a plane whilst the expectation is a safe journey and arrival, it is understood things could go wrong. The choice of the airline based on safety record and flight path are important elements in determining risk. Similarly, for your surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk. Risks, both general and specific, will be discussed during your consultations and written information will be provided for you to take home.    

General risks include pneumonia, deep venous thrombosis and pulmonary embolism, stroke, heart attack, allergies, awareness, death, bleeding, infection, sensation change, haematoma and seroma, skin contour irregularities, damage to deeper structures, firmness, delayed healing and tissue death, exposed sutures, dog ears or additional skin golds, dressing issues, asymmetry, scars, lymphoedema and unsatisfactory results. 

Risks specific to Blepharoplasty (Eyelid) surgery are:  injury to the eye globe, need for extra tissue,  loss of vision, changes to tear secretion,  conjunctival oedema and chemosis, exposed sutures,  upper eyelid malposition, difficulty closing the upper eyelid and corneal exposure, lower eyelid malposition and eyelash loss.                                

 

BEFORE AND AFTER PHOTOGRAPHY

Our practice privacy policy prevents sharing patient before and afters online. Indicative before and after photos can be viewed during your consultation.  

 
DISCLAIMERS:   All surgical procedures are performed by Specialist Plastic Surgeon, Dr Naveen Somia (MBBS PhD, FRACS - APHRA Reg:  MED 0001189889).  For full information on Dr Somia's qualifications and risk/recovery information on procedures please visit the procedure page on this website.  From July 1, 2023 all surgical procedures require a GP referral.
 
All surgery carries risks.  information provided is general only.  Outcomes experienced by one person do not necessarily reflect the outcomes of others given factors such as genetics, diet and exercise.  Please seek a 2nd opinion from a qualified Specialist Plastic Surgeon.  

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or call: 02 9387 2110

fracs

Royal Australasian College of Surgeons

psruol

Plastic Surgery Research University of Louisville

trcosof

Royal College of Surgeons of Edinburgh

paces

PACES Plastic Surgery Atlanta USA