I have fat creases or bags under my eyes. What can I do? (Photo)

I have these fat creases under my eyes and it's reallyyyy bugging me. I absolutely hate them. What is it? When I google fat creases or bags it's not the same as mine so I don't no where to look for help. It's really noticeable when I smile. Please help... I'm only 25 :(

Doctor Answers 4

Deep set eyes

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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. 


Dr. Yang

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New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Deep set eyes

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Your eyes are beautiful. And no, you don't have "fat creases". You simply have deep set eyes. Learn to love them as they are one of the features that make you unique. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Bags under the eyes

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From the pictures you submitted, it seems that these bags that you refer to are not fat pads under the lower eyelids. They are mostly caused by an excess muscle under the eye, and hey are shown every time you activate this muscle when you smile. This excess muscle can be easily removed permanently by preforming a Lower Blepharoplasty (Eyelid Surgery). Hope this answers your question. 

Luis Pedroza, MD
Colombia Facial Plastic Surgeon

Creases under the Eyes

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What you have is not "fat creases," but muscle. This is normal and there is nothing to do about it. They are more noticeable when you smile since the muscle is active then.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.