Why Are my Eyes So Puffy? (photo)

My eyes are always puffy. Some days more than others. They are always sensitive to the wind to the point where they tear. I do get enough sleep and there is no change. When I squint my eyes I can see a sac within the bag and when I push on it, it disappears until I quint again. What's wrong with my eyes? I do not want surgery.

Doctor Answers 2

Your eye irritation and puffy eyes are not related so they should be treated separately

As an oculofacial cosmetic surgeon, I've had tremendous experience with situations like yours. The bags or the puffiness around your eyes and the sensation of your eyes are basically unrelated. Eye sensitivity is likely due to dry eyes and allergies that should be checked by an ophthalmologist. Puffiness around the eye can be further enlarged from the effect of allergies but there’s no direct association between puffiness and eye irritation.

With the photo you submitted, there’s a bulge of swelling which appears to be lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that’s normally around your eyes pushes forward and herniates, and is called herniated fat. In the early stages of fat prolapse, people notice that that there are days they don’t see it and other days that they see it a lot. Most of the time, people come to me because they’re having more bad days than good days. Some people will start their own treatment by going to some drug store chains, makeup counters, and beauty cosmetic places and they’ll try to get topical under eye creams. Unfortunately, none of them will work because puffiness related to fat prolapse will not respond to creams. There are also some people who will get some fillers and place it in the tear trough area or the rim underneath the eye to try to camouflage the area, but fillers have a threshold and can make the eyes look puffier.

When it comes to the dynamic activity that is demonstrated when you squint, there’s a second part of the anatomy that you can be aware of which involves a muscle called the orbicularis oculi. This is a muscle around the eyes that contracts in facial expressions. Its contraction makes the muscle bigger and causes a ridge to form in the eye area.

I think you should ask yourself how much of that puffiness under your eye bother you. As much as you don’t want to have surgery, this may he right choice for you, but I think seeking some professional opinions is the appropriate step. I suggest that you see an ophthalmologist to manage the eye irritation and ask him about the allergies underneath your eyes. After that, based on your concern about the appearance of the puffiness under your eyes related to fat prolapse, I recommend that you visit a surgeon for an effective treatment because they can address the full range of issues, rather than a non-surgical physician who has limited treatment options. I hope that was helpful, and thank you for your question.

New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Puffy eyes

Thank you for asking about your puffy lower lids.

  • You have a excess fat in the lower lid, it probably runs in your family,
  • When you have a surgical problem - surgery is best.
  • A lower eye lid lift - transconjunctival blepharoplasty - will correct this,
  • But if you don't want surgery, filler injections may partially conceal the fullness but results are not permanent and are less predictable.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 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.