Are these eye bags / dark circles? Why under my eyes always puffy? (photos)

Hello @Tarek jalani, thank you for your question. The reason may be genetic or if the patient lives in a place where the climate is very cold, they tend to develop rhinitis and generate swelling in the palpeolar area. If the edema is already too much you can consider a corrective lower blepharoplasty because in that case non-surgical treatments cannot do much. The pigmentation is caused by the shadow that is generated if you wake up in the morning and is more swollen or at night when you stay awake is more swollen, that will create a pocket that produces a shadow that generates pigmentation. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Thank you for submitting your question and photos. The area surrounding the eye you’re referring to is often the first place to show signs of aging. The muscles in this area can weaken over time, causing the skin to become increasingly loose and puffy.
A lower blepharoplasty procedure can tighten the weakened muscles and reposition fat below the eye to add volume and create a firmer, more youthful appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your concerns and suggest the best course of action for you.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.