As a cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for over 20 years, I deal with this situation every day. I first explain to my patients the cause of the bags. In your situation, one of your bags is from the eyelid margin or the eyelashes to an area before the second bags begin, which is actually a muscle called the orbicularis oculi muscle. This muscle is activated when you smile and has the tendency to bulge when it contracts. I don’t really recommend doing anything for that because it’s a muscle that you need that supports the lower eyelid. We periodically do a trial of neurotoxin like Botox® which is non-surgical and see if it contracts a little less. However, you can’t relax it too much otherwise you are at risk of the lower eyelid sagging. The puffiness in the lower area despite the use of creams is due to lower eyelid fat prolapse. From your photos, it is clear that there is a bulge of fat that has moved forward. The procedure for that is lower eyelid blepharoplasty. If there was a non-surgical option, then blepharoplasty would not be one of the top 5 most popular cosmetic surgical procedures. In addition, a lot of devices are marketed to try to non-surgically treat this area and people try to camouflage this with all kinds of injectables. Unfortunately, at a certain point, none of those things can really make a difference because the anatomy is very straightforward -it’s fat that’s pushed forward. MRI studies have shown this to be fat that has increased in volume. It generally runs in families, and I've had the privilege of operating in 3 generations. My recommendation would be to do a transconjunctival blepharoplasty. I would address the fat pockets from the inside of the eyelid to avoid any external scar. At the same time, I reduce the puffiness and create a contour either through the removal, sculpting and repositioning of fat so that it looks like you never had the bags to begin with. Those fat pockets don’t come back. We perform this surgery under local anesthesia with LITE™ IV sedation in our Joint Commission facilities in our offices. Over 20 years, we’ve worked on developing systems and processes so that people would not have an aversion to surgery. We do everything to make people comfortable. Lower eyelid surgery can be complex. Unfortunately, many people do have some complications. As a specialist, I get to fix those complications. We get patients from around the world to have these procedures revised whether it’s residual fat or fat transfer that have to be removed. Patients also have lower lid retraction where the eyelid was pulled down, and ectropion where the eyelid was everted out. In spite of all those potential complications, it can be a remarkably satisfactory surgery when performed well in good hands. Every surgeon has to deal with these issues no matter how good they are and how much experience they have. My advice is that you meet with qualified, experienced cosmetic surgeons and have a physical exam. Determine the kind of doctor you feel has the level of expertise, knowledge and experience that you trust to have your eyelid surgery performed. Otherwise, you will be spending a lot of time and money on things that are not likely to work. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.