What Are my Best Options to "Depuff" my Lower Eyelids? (photo)

Hello. I am 26 and have always been insecure of my bags! I've had them as long as I can remember. My father is Turkish and has large under eye bags- Anyway- mine are a little different: they are extremely puffy when I wake up or cry-and most of the time the swelling slowly goes down a little. I was reading into fillers under the eyes but am worried how you would know how much to put in since there not always the consistent about of fluid in my eyes? Please help me with some options- Thank You!

Doctor Answers 10

Puffy eyes

The puffiness in that comes and goes in your lower lids is interstitial fluid trapped in the fat bags. This cannot be treated with fillers.  A transconjuctival lower blepharoplasty will address this problem of looking tired by removing the  fatty deposits.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Fat Removal

Thank you for your question. While filler injections to camouflage eye bags typically works well in young patients, your description suggests that the eyelid swelling proccess is ongoing. Swelling that cycles could be exacerbated by fillers. Removal of the fat pocket via an incision inside the eyelid would be a better option.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Non-surgical eye bag treatments

Fillers below the eyelids will typically correct most of the bulge in mild eyelid bags.

Restylane and Radiesse are good preliminary options.

Fat injections, surgical excision and the Cellulaze Sidelaze laser offer longer lasting results.

It is usually safest to start out with less.


Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Puffy Eye Options

There are two options here: 1 - a blepharoplasty to surgically remove the fat pad under your eye causing the bag through a tiny incision on the inside of your lower lid and 2- using fillers like Radiesse or Restylane to camoflauge the bags. Don't let any cream fool you: this problem simply can't be addressed with topical products, as it is an anatomical problem. Fillers are temporary, but quicker, cheaper, and easier. Blepharoplasty has minimal complications, and results in permanent change. It's really up to you. You can learn more about both options in depth on my website (link below). Best of luck!

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews



The procedure that will give you the best and longer lasting results would be the blepharoplasty (eyelid lift). You do have other options but it all depends on what kind of results you are looking for.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 reviews

De-puffing your eye bags with a natural look

Thank you for your question. A lot of people think that puffy eyes are caused by fluid, or from salt intake, or even allergies. These factors can make your eyes temporarily puffy. If your eyes are puffy all the time, judging by your photos you most likely have lower eyelid fat prolapse.  This happens when a normal amount of fat around your eyes are pushed forward, causing it to form puffiness around your eyes.  Most people would buy all kinds of creams they can find from drug stores just to reduce their eyes’ puffiness.   However, what is causing their eyes to get puffy are happening in the inside, so treating it on the outside with creams and the like aren't  going to help much.

Injectables are an option, but I use these in cases where the puffiness is minimal. However, when using injectables the puffiness may still be there, and blending it can make your eyes look even puffier. Based on the photos you submitted, the best treatment for de-puffing your eyes  is with lower eyelid blepharoplasty. With this procedure, we can avoid any incision that might cause scarring. Even your eye doctor will have a hard time noticing that you had any work done.  There are various techniques in doing this, and it takes some finesse.

When considering this kind of procedure, I advise you to do your research and find a qualified cosmetic surgeon that has extensive experience in the eye area.  I hope this helps you.

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

26 year old with puffy lower eyelids

First control all non-surgical causes of the puffiness.  Does the puffiness get worse during allergy season or in contact with animals?  If any suggestion of allergies, bring these under control first.  If the puffiness is the same year round, it is probably due to true fat herniation.  In a young person like yourself a transconjunctival approach (through the inner lining of the eyelid) should be considered.  Remember that surgery won't correct the excess pigmentation of your skin.  I use fillers frequently to help patients in the tear trough area, but I don't feel that in your case fillers will accomplish their objective.  I hope this is helpful.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Treatment of lower eyelid bags

Thanks for your questions.  When treating lower eyelid bags it is important to determine the cause of the problem: too much fat, loose eyelid muscles, or too much eyelid skin.  Based on the pictures it seems that there is just excess lower eyelid fat.  This can be easily corrected with a surgical procedure that involves removal of the fat.  That type of procedure creates permanent improvements.  I would caution against fillers based on the pictures.  Fillers work well when there is a deep groove but they don't work well when the fat is bulging out.  I hope this helps.  If you are really interested in pursuing this you should consult with a board-certified plastic surgeon.  Good luck!

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 126 reviews

Puffiness under your eyes

Thank you for sending and showing your photo.  As you have suggested, this puffiness is genetic.  It comes from weakness of a connective tissue layer that separates the fat cushion around your eyes from the muscle and skin.  While it is genetic, it tends to worsen with age.  This is a situation where fillers (Restylane) can help to disguise the problem.  However, surgery is very effective, is a permanent "cure" and gives you predictable results.  This is true despite fluctuation in the puffiness from crying, lack of sleep, etc...  

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 87 reviews

Puffiness of lower eyelids

Sometimes people do get puffy lower eyelids which are due to hereditary causes and not aging.  There are basically two options to improve the puffiness.  One method is to have surgery to remove the fat that causes the bagginess.  The other method is to inject a filler below the fullness to help blend the area better.  An experienced injector can determine the correct amount of filler to use to give you the best result.  I would recommend Restylane for that area if you decide to go with the filler and not surgery.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.