Hi Sarah,You have beautiful eyes. The bulge directly under your lower eyelashes along with the crease directly below it is actually a result of having deep set eyes. Some people naturally have this feature even when they were a child. These children have beautiful big eyes, and their eyes look more mature than other children. Typical young looking eyes are puffy with more skin showing on between the eyebrow and the upper eyelid fold (think Jennifer Aniston), and on their lower eyelid their cheek is full and appear to go directly to their lower eyelashes without any indents/shadows or folds. Children's faces also appear flatter and more shadowless. Their eyes protrude more and appear level with their cheek and forehead. As we get older, this extra fat (baby fat) goes down and their faces become less chubby and more sculpted. The eyes become more deep set and the fat that hid the lower edge of the eyeball also goes down. For some bone structures, this results in a bulge and fold that is directly under the eyelashes, but at the same time is not a "tear trough."If you follow the contour of your eyeball and look the the bulge, you will be able to see that this is not just muscle "hypertrophy" as most doctors will diagnose. It is really that the lower eyelid ski is hugging the shape of the lower part of the eyeball. If you push on the bulge you will feel direct pressure on the lower part of your eyeball. If you feel the groove below the bulge, you will feel the gap which is a space between the eyeball and the rim of your eye socket. In a traditional eye bags, the people will have a pad of fat between their eyeball and the rim of their eye socket. For people with no eye bags at all and appear to have their cheeks go directly to their lower eyelashes there is more fat directly under their eyeball, and typically fuller cheeks. In my practice, I ask the patient to bring in younger photos of themselves for comparison. If their face changed and they had their cheeks flow smoothly to their lower eyelashes, then there are some specialized techniques to try to restore the more youthful shape. However, some patients feel that they looked puffy when they were younger and as they lost some of their baby fat and their eyes became more deep set, they became prettier/more beautiful. These Q&A forums are not ideal for answering technical questions since diagrams and pictures would help along with the explanations.I hope this helps to shed some light on your situation. Best,Dr. YangP.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.P.P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.
