My under eye bags are heavy and make me feel tired all the time on top of being ugly to look at. What are my options? (Photo)

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eyelift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression.
I hope this helps!

The ideal treatment to address both under eye fat bags and tear trough hollowness is transconjunctival lower blepharoplasty with fat bags repositioning to fill the hollow area. See following surgical video and website link. See an oculoplastic surgeon.

This could be addressed with lower eyelid surgery.  It could also be addressed with a chemical peel or possible a combination of the two.  If you were motivated, I suspect you could also be filler but this nonsurgical approach will be fussy and you are unlikely to find an injector close to home who can get this done for you in a satisfactory way.

You have excess fatty tissue under your eyes which is making them look puffy. It looks like you are a good candidate for lower blepharoplasty surgery. A skin pinch may also help with the loose skin but you would need an in person evaluation to determine an exact plan. Make sure to find a surgeon experienced in eyelid surgery.

Thanks for sharing your question and photos. You have both surgical and nonsurgical options. I will focus on nonsurgical treatment options because that is what I do. A filler such as Restylane could be injected into the undereyes to correct volume loss and dark circles. This could be combined with a treatment to improve the quality of your undereye skin such as Thermage FLX, microneedling, or fractionated lasers. Of course, I recommend you continue using good sun protection, an antioxidant and retinol. 

Based on your photos I think your best option is surgery.  With a lower blepharoplasty excess skin and fat is removed.  Remaining fat is redraped revealing a smoother under eye.  You can try non surgical options such as the ALMI treatment which uses your own tissue to improve volume, tone and texture.  Fillers are also an option, though temporary.  I recommend beginning with a consultation to determine what is best for you.

From these photos, it looks like you would get a homerun result with an upper and lower lid TC blepharoplasty. This procedure would make you look more rested and open up your eye. In my experience the most important thing in assuring a quick recovery from blepharoplasty is minimizing bruising and swelling. Bruising is much easier to prevent that to get rid of. I have all my patients ice as much as possible from the time they get home until they go to sleep that first night. And I instruct them to not recline any more than 45 degrees until they go to sleep that night. And stay away from salt. Patients who follow these instructions generally heal very quickly with little or minimal bruising or swelling. See a board certified surgeon in your area with an expertise in aesthetic surgery for more information. Good luck with your procedure!
Dean Vistnes, M.D. Vistnes Plastic Surgery San Francisco Bay Area
#realself #drdeanvistnes #blepharoplasty

Thank you for your question and photograph.  Puffy eyes or eye bags are caused by a herniation or protrusion of normal eyelid fat which pushes out on the lower eyelid skin as we age.  In addition to aging congenital or hereditary factors can also contribute.There is also some minor loose skin of the lower eyelids.  The most definitive procedure to correct these problems is a trans-conjunctival lower eyelid blepharoplasty with arcus marginalis release and fat grafting and the skin pinch blepharoplasty to tighten the skin along with a procedure: Orbiculopexy to tighten the lower eyelid muscle.Please consult and experienced board-certified plastic surgeon or oculoplastic surgeon for proper examination, diagnosis and recommendations.