What can be done about the sudden onset of eye bags? (Photo)

Thank you for your question. You submitted a photo, and ask what to do about under eye bags that appeared suddenly about a month ago.
I can give you some guidance on my impression based on your single photo, in the absence of a physical examination, and share with you what I tell my patients who have similar situations as yours. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people with under eye bags is something we do in our practice every day. This type of scenario where patients come to me and say suddenly, overnight, they have under eye bags.
From my perspective, just understanding the anatomy, it’s a little unusual for someone to have developed eye bags suddenly. A more plausible is you’ve had varying degrees of puffiness, and at a certain point, it became constant. Often patients will tell me there was a time before they came to consultation where they would get puffiness, but they would do a variety of things, get a good night’s sleep, and would look good the next day. Then it would be described often as not so good days compared to very good days. Then the not so good days outnumber the good days, then they would seek attention.
That said, it is always important if there’s a big change in your appearance to always check with your medical doctor to make sure your general health is fine, and there’s no issue with kidney function, liver function, etc. Assuming you are healthy, you can at least understand what is causing the puffiness.
From this photo, it looks like you have  lower eyelid fat prolapse, meaning the fat normally around the eyes pushes forward, and creates this bulge which results in constant puffiness. Routinely in our practice for people like yourself, we do a procedure called lower eyelid blepharoplasty where the puffiness is addressed surgically.
Most people are hesitant to have surgery, and try to it with non-surgical things like creams or injectables. There’s a role for non-surgical options, and in our practice I routinely help patients with a mild amount of puffiness under the eyes with injectable fillers to help blend the transition between the puffiness and the tear trough area. In your situation however, I think the puffiness is more prominent, and likely needs a surgical solution.
When choosing a surgical solution, there are two options: one is doing the procedure from the outside called transcutaneous blepharoplasty, or from the inside called transconjunctival blepharoplasty. In my experience, and for a wide range of patients, I routinely address the fat pockets from a transconjunctival approach. That means working from behind the eyelid to address the fat pockets,reduce them, and sculpt them accordingly.
Often people are afraid that if we do just that, what are we going to do about the skin? Won’t there be excess skin? I help patients understand that it’s not excess skin most of the time, and it’s actually about skin quality and not skin quantity. Particularly for males and people in their 40s and older, tendon laxity and support of the eyelid is very important. There are other variables that also play a role in this decision. Unfortunately, we have patients who come to us from all over the world with complications because their eyelids would be retracted or everted from having surgery done in a way which doesn't address all of the anatomic variables affecting the position of the lower eyelid, so they need revision surgery, and often complicated revision surgery.
When I am asked about skin quality or wrinkling, I tell my patients we routinely treat under eye wrinkling and skin quality with a combination of platelet-rich plasma (PRP) which is derived from your own blood, to stimulate collagen and improves the skin quality. We often combine that laser whether it’s fractional CO2 or Erbium to freshen up the skin, and improve some of these texture issues. Globally between the puffiness and skin quality improvement, you look better. What’s really great about the under eye area is that it has such a big impact on the whole face, because bags under the eyes really makes the face look tired.
I think you’re on the right path. As far as the issue of overnight, as I said, make sure you see your medical doctor to make sure everything is okay, but this is more likely just a cosmetic issue, and a change that became more persistent. You are in a situation that can be addressed surgically.
Meet with qualified, experienced cosmetic surgeons and learn about your options. Learn about the style in which your doctor approaches this issue. Look at before and after pictures, and as often is the case, people want to choose a doctor based on the type of anesthesia they have to undergo. We have patients who come from all over the world who come to me besides the reason of specialization, because I do these procedures in my office under local anesthesia with LITE™ sedation, thereby avoiding general anesthesia altogether. This way, our patients are able to be up and ready to leave without feeling any of the nausea and other  issues related to general anesthesia. This has to do with the surgeon’s preference, and whatever the surgeon is comfortable with. In my practice, we developed a nice system that works out very nicely to help people have the procedure with minimal sedation so they don't have the anxiety during the procedure, avoiding general anesthesia, and comfortably healing so they can get back to normal life in less than a week. I hope that was helpful, I wish you the best of luck, and thank you for your question.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.

Unfortunately, as we age, the skin under our eyes can get very thin and loose.  In addition, fat pads that sit high on our cheeks when we are young tend to diminish in volume and fall towards the lower part of our face, which accentuates the appearance of bags under the eyes.  If you also happen to have a genetic tendency towards under eye bags, then this process can be even worse and can definitely seem to appear over night!The good news is that the surgery to correct this is easy and safe.  It is called a lower blephoplasty.  If you want to pursue non-surgical options, you could consider putting some filler into the area under the eyes in order to "hide" the bags and/or a procedure such as J Plasma that stimulates collagen production and tightens skin.