Treatment of Swollen, Puffy Eyes
There are essentially two different issues to your question. The puffiness of your lower eyelids would probably be best treated with a blepharoplasty. The dark circles are a more difficult issue. Sometimes there can be a vascular issue that may be addressed with a laser and there can be issues with hyperpigmentation that can be treated with creams. Often these cannot be completely corrected
Lower blepharoplasty vs filller injection
The answer depends on how much relative puffiness (fat) is present relative to dark circles (hollowness) underneath the puffiness. If there is more puffiness, then lower blepharoplasty with fat repositioning if the best option (which can be done under local anesthesia). If there is more hollowness present, then filler injection is the best option.
Possible Blepharoplasty Candidate
Photographs and an exam will be able to determine if the problem of the bags is actual fatty deposits that need to be removed via blepharoplasty. If these are just hereditary sad pads as we call them then it is a different story which you may treat with fillers. Best regards, Michael V. Elam, M.D.
Puffy eye treatment in the young patient.
Puffy eye treatment in the young patient is treated with a blepharoplasty if these are true bags. An exam will answer the question.
There is no substitute for an actual physical examination in person.
The reason for this is that terms like "swelling," "puffy," and even "prominent purple dark circles" mean different things to different people. To complicate matters more, the anatomic basis for things that generally appear somewhat similar can actually be very different. You also chose not to provide a photograph.
There is a condition seen in young people that does cause puffy lower eyelid from inflammation but this is rare. More likely you are describing contour issues of the lower eyelid that for your age most likely will be very effectively addressed with hyaluronic acid fillers. The best of these products for the lower eyelid is Restylane.
When you are ready, an in person consultation with a very experienced aesthetic oculoplastic surgeon will help you have a clear idea on how to proceed. Generally diuretics (water pills) are not helpful. Surgery may be an option but many, many individuals your age are avoiding surgery with the use of fillers.
True puffy eyes or eye bags require surgical treatment
Thank you for your question. True puffy eyes or eye bags are caused by fat beneath the eye pushing forward on the eyelid skin. This condition requires a surgical treatment called lower blepharoplasty to remove the excess fat and correct the puffiness.
Dark eyelid skin color is a normal human condition caused by skin that is so thin that the purple color of the muscle beneath shows through the skin.This is very difficult if not impossible to treat.Small blue veins scan be corrected with IPL treatments.
Deep depressions or dark circles can be treated with fat grafting during the course of the lower blepharoplasty.