How should I get rid of and what may be the cause of bags/discoloration under eyes? (Photo)

I think it may be from dehydration and drinking a little too much but I have improved that for last week and still not getting much better. I am Only 32 and feel like it really ages me

Doctor Answers 9

Dermal Fillers for Under Eye Darkening

Hi Tina. The concern that you mention looks like it relates to the darkening of the area under the eye shown in the first photo and the groove (nasojugal) that is present between the nose and under eye area.  This concern is best addressed with Restylane injections and you can see many examples at the link below of our Orange County patients like you that have had the procedure.  1 - 2 CC's of Restylane is your best bet and results last 6-12 months.  

Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Lower eyelid puffiness

In the first photo, it appears you have some protrusion of the lower eyelid fat pads. Often this is hereditary (especially at your young age), but can be exacerbated by diet, environmental factors and certainly by things that can increase inflammation like smoking and alcohol intake. Try to minimize those factors as much as possible. If you still feel like there is protrusion of fat in the lower eyelids, you may be a good candidate for a transconjunctival lower eyelid blepharoplasty, which involves an incision on the inside of the eyelid and removal of some of this fat in a controlled manner. Good luck!

Katherine Zamecki, MD, FACS
Danbury Oculoplastic Surgeon

The under eye bags can be removed with surgery, or blended with a filler. Discoloration can be treated separately

Thank you for your question. You’re 32-years-old, submitted 2 photos with your concern about how to get rid of under eye bags and discoloration, and also ask about the cause. You also state you’ve had some issues with dehydration and drinking a little too much, but have improved over the course of a week.

I can give you some guidance on how I approach people like yourself in our practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. Under eye bags is one of the most common issues we deal with in our practice for over 20 years. It‘s important for you to understand the cause before considering the solutions.

The most important issue besides the underlying cause of your eye bags is your general state of health. It’s my duty to at least advise you to also manage and minimize alcohol consumption, anything that causes dehydration, and do what is best for your general health. I am a proponent of healthy lifestyle and healthy living, so there is nothing that better for any outcome for any procedure than a patient who takes care of themselves. Someone who smokes, doesn’t eat enough, and doesn’t sleep well is stressing their body. With that point made, let’s look into the anatomic issues.

Puffiness under the eyes is caused by lower eyelid fat prolapse, meaning the fat normally around the eyes pushes forward and creates this bulging, The fat is persistent, so you look tired all the time, or like you haven’t slept. Very often, people tell us they are asked constantly if they slept enough, or if they have been doing drugs or drinking. Under eye bags communicate many things that are not advantageous.

Discoloration of the skin does have many different levels -  the external element of the skin called the epidermis, to the dermis level is affected by the environment like sun exposure, smoking, or general environment like wind, even eye rubbing or allergies can have an impact from the outside. In the deeper levels, what is often the case is the skin is very thin, so you can actually see through the skin to the underlying structures like the blood vessels and muscle.

When we address patients with obvious constant puffiness with discoloration, the approach I generally take is to o reduce the puffiness is a lower eyelid transconjunctival blepharoplasty.This means we are addressing the fat pockets causing the bulge from the inside the eyelid. This is done under local anesthesia with LITE™ sedation. From the outside to deal with the skin quality, we address the skin in two directions. Under the skin, we treat the skin with a material from your own blood called platelet-rich plasma (PRP), which is a concentration of the wound healing and growth factors so eyelid skin which is barely half a millimeter in thickness has some more quality and volume in terms of collagen and blood supply. From the outside, we can improve the skin quality with something like a fractional erbium laser or CO2 laser to help tighten and resurface the skin, so new skin comes in and improves the overall appearance.

If you went for a consultation and it appears you don’t have much fat prolapse and want to improve the skin quality,  there is an option to do this less invasively. Fillers such as Restylane or hyaluronic acid into the area called the tear trough to soften the transition between the under eye bag and the adjacent lower eyelid so it doesn’t look as puffy because the puffiness makes the hollow look deeper. You can still use platelet-rich plasma (PRP) to benefit synergistically in improving skin and tissue quality when combined with a hyaluronic acid filler.

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.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

How should I get rid of and what may be the cause of bags/discoloration under eyes?

You could consider Hydroquinone 4% solution two times a day or another option would be laser skin resurfacing.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

can be hereditary and exacerbated by lifestyle. They can be treated
with lasers, fillers, microneedling/PRP and skin care.Please
see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

Lower eyelids

Hello there, you may benefit from having either lower lid fillers vs lower lid surgery.  I would recommend you to see an eyelid specialist who can better determine your best option. Best of luck! Dr Zoumalan

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 102 reviews

How should I get rid of and what may be the cause of bags/discoloration under eyes?

Fraxel® light resurfacing is my got to treatment of choice for under eye area. As this is a very innovative technique, please consult a board certified aesthetic dermatologist for a consultation.

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 9 reviews

How should I get rid of and what may be the cause of bags/discoloration under eyes?

You have under eye bags which is eye socket fat that has come forward with age.  A long term solution to under eye bags (orbital fat prolapse) is lower blepharoplasty, which is best done through inside eyelid (transconjunctival) approach with fat repositioning. (Another option that camouflages the bags but doesn't get rid of them is filler injection.)  See following video and link.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Under eye shadowing and fat bags

Your under eyes demonstrate fat pads that are pushing through and creating a bulge that results in the shadowing effect and groove that you don't like. It is likely that your genetics predisposed you to this at an early age. If you want definitive and permanent correction, you should consider a lower blepharoplasty. Please see examples below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

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.