Non-surgical Treatment for Undereye Bags?

Is there a non-surgical way to treat bags under the eyes? I'm getting to the age where they are starting to become noticeable (I'm 41), so is there any drug or process to eliminate them at least temporarily? I'm really not interested in surgery, but I also don't want to waste my time.

Doctor Answers (21)

There is No Effective Non Surgical Treatment for Under Eye Bags


Thank you for your important question.

Puffiness of or Bags Under Eyes is a structural problem caused by excess or herniation of eyelid fat bulging against the eyelid skin.

This fat must be repositioned and or removed to remove the puffiness or bag.

Do not believe ads that say a cream or laser treatment will remove puffiness or eye bags-they will not.

Fat injection and Filler injection such as Restylane can camouflage the problem but injections into the eyelid can be dangerous and should only be done by an expert who is familiar with this technique

Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Restylane is an excellent filler for minimizing under eye bags


Restylane is a great product for injecting under the eyes, in the "tear troughs". Filling this area reduces the appearance of the under-eye bags by providing a smooth transition between the lower eyelids and the cheeks. The skin in this area is very thin and therefore this procedure should only be performed by expert injectors. The advantage of Restylane is that in the event of a lump or irregularity, the product can be dissolved. A recent scientific paper demonstrated that the product can last up to 2 years in this area.

I utilize a number of other fillers in my practice (e.g. Juvederm, Radiesse, Perlane, Sculptra, fat transfer) for other areas of the face, but I would only recommend Restylane under the eyes. For patients open to the idea of surgery, a lower blepharoplasty with fat repositioning is also an excellent option. 


Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Lower eyelid bags


There is no good cream or non-surgical treatment for lower eyelid bags. If you, however, have a hollow appearance under your eyes, you may be a candidate for an injectable such as Juvederm, which can temporarily fill in the area and soften the look of the "bags". If, however, there are actual "bags" under your eyes, then only surgery will help at removing some of the excess skin and/or removing/repositioning the excess fat deposits.

Please consult a board certified plastic surgeon prior to scheduling a lower eyelid procedure.

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 134 reviews

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Restylane might help


At 41, you might have early tear troughs making it look like you have buldging fat bags above them. It may be that rather than needing fat removed or repositioned, you could mask the tear trough very effectively with Restylane. I have had many patients with this and they have great non-surgical results that last a year or longer.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 47 reviews

Nonsurgical Lower Eyelid Options


Most commonly, bags refer to bulging or puffiness immediately under the lower eyelashes. This is orbital fat that has nothing to do with weight gain or weight loss but exists to cushion the eyeball. It is held back by a membrane but as we age, or because of genetics, the membrane can weaken and the fat starts to push forward. If that's all that is present, an incision can be made on the inside of the lower eyelid and the fat can be removed. This is called a transconjunctival blepharoplasty. Alternatively, if under the age of 40, using a filler such as Belotero around the bag can camouflage it's appearance and works very well.

Bags are usually associated with a shadow or hollowing just below the bag. The shadowing or hollowing below the 'bag' occurs because of a different type of fat pad. There is fat on the bone below the 'bag' and that recedes as we age. The shadow occurs because you have some fat receding and the fat cushioning the eyeball starts to move forward which creates a shadow below it. Some people refer to this shadowing as their hollow, dark circle, or tear trough. Again, this hollowing can be filled to decrease the fat lost in this area. This can be performed with fillers such as Belotero, Perlane, or Voluma, fat injection, or using a tear trough implant. It can also be filled by reusing some of the fat that is removed from the 'bags' at the time of a blepharoplasty, and placed into the tear trough region as a fat transplant or transposition.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Non-surgical Treatment for Undereye Bags?

In smaller amounts of puffiness a nonsurgical option is filler injection - Juviderm or sometimes Voluma.  This is done in the area where the lower lid meets the cheek.  We call this the "tear trough".  A plastic surgeon skilled in injecting this area is needed since the skin is very thin and the product needs to be placed in exactly the correct location for optimal results.

Susan D. Vasko, MD, FACS
Columbus Plastic Surgeon
4.5 out of 5 stars 3 reviews

Non surgical treatment of lower eyelid bags / "tired appearance"

Dear Eva,

I often treat lower eyelid bags with a filler treatment using a microcannula to give smoother contour to the lower eyelids and "mask" the bags.  This has allowed many of my patients to be able to hold off on lower eyelid surgery.  Be sure that only a microcannula is used when having this procedure done to minimize the risk of complications that can occur when injecting fillers around the eye.  

Kian Karimi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Under eye bag treatment

There are many things physicians are using and trying to reduce the bags under one's eyes.  The most important thing here is to have a proper physical exam – what are the reasons the bags are there in the first place.  Sometimes topical therapy will improve things and there is a new topical cosmeceutical called Neotensil which has been shown to temporary improve bags under the eyes.  Lasers and RF devices can tighten the skin and are useful here. Dermal fillers, such as Restylane, can also produce nice results. So a number of things can be done, all non-invasivley to make these annoying things look better.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 3 reviews

Nonsurgical treatments for under eye bags

Nonsurgical treatments for under a bags include making sure that all allergies are under control, chronic sinusitis is under control, low thyroid conditions have been ruled out, and low-salt diet has been tried. If the bags are still present, consideration for surgical removal of  conservative amount of fat that creating the puffiness look through a transconjunctival( inside the eyelid) approach under a very brief general anesthetic. We do not recommend fillers placed around the eyelids. For many examples, please see the  Link below to our surgical blepharoplasty photo  gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 54 reviews

Lower lid puffiness eye bags

A transconjunctival Lower eye lid surgery or blepharoplasty is permanent way of removing the bags without any scarring.  It costs around $2500.  Fillers such as Restylane can be used to "hide" the bags depending on overall presentation.  This could cost around $450

Afshin Farzadmehr, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.