Are my under eye bags fat pads or water retention? (Photo)

It's not water retention. It's just your anatomy. For now, I would start with a good, light illuminating creamy concealer. With perhaps a color corrector for dark circles in the inside corner. Down the road, you may want to consider a HA filler such as Restylane in the tear trough area, but not now.  
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Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Hello anfjk,Thanks for your question.I think that what you are seeing frankly is not eye bags or water retention.  What I think you have is a lower orbital bony rim that is set back exposing your normal muscle and lower lid fat pads.  I agree that eye creams and concealers are good options.  You can also entertain having injectible filler material placed to camouflage the hollow that you see below the bulge.  Finally, you can have a fat transposition eyelid surgery that can move the fat in your lower eyelids into the hollow to smooth out the area.  The most aggressive thing you can do is to place either orbital rim implants or tear trough implants into the area to make up for your natural bony deficiency that caused this issue in the first place.All this being said, I recommend you go see a specialist in lower eyelid aesthetics to discuss your various options.  I would recommend either a plastic surgeon who specializes in eyelid surgery/facial implants or an oculoplastic surgeon (an ophthalmologist with special training in orbital plastic and reconstructive surgery).  They can discuss all of your options, not just eye creams and injectibles.Additionally, if you plan on surgery wait until you are at least 18 years old and take the time to understand all the risks and complications.Good luck,Dr. Shah

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately. All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

These can be caused by fat or it can be caused by your orbital rim.  Given your age, try moisturizers and under eye concealers.  Under eye fillers require a medical service but the effect is remarkable and for many years, this type of service done by a very experienced injector can give you everything you need without surgery.

Hello Anfjk,Eye bags develop because of the fat around the eye pushing forward.  When the swelling is caused by water retention you see a fluctuation in the swelling during the day and after certain meals.  A heavier salt meal will cause them to swell more.  It is more likely these are related to the fat around the eye since you have had them since you were born.  The simplest and least invasive solution is to use makeup to conceal the area.  This doesn't get at the root cause of the problem and the results aren't the best but it is an option.  Another option is the use of fillers.  The reason the bags are so prominent is they are creating a shadow in the tear trough (the area between the nose and lower eyelid).  Fillers could be used to blend this area better so the shadow can be improved making the condition less noticeable.  The fillers can last up to a year but do require repeat injections.  The final option would be surgery.  The incision could likely be placed right behind your lower eyelid in the pink of the eye to avoid any external scars.  The excess fat could then be partially removed and partially repositioned over the tear trough.  This is the most invasive option but would likely provide for the greatest result.  I would recommend you consult with a facial plastic surgeon, plastic surgeon, or oculoplastic surgeon to have a complete evaluation and determine what is the best treatment option for you.  Since you are 17, make sure you bring your parent with you as you cannot receive any treatment without their permission in Texas except under very specific circumstances.  I hope this helps and good luck.