Reason why I suddenly got under eye bags...what type of treatment should I look for? (photos)

I'm 30 years old and suddenly got under eye bags. I hate my picture being taken now and they age me so much. My mother has bags, but didn't get them until she was near 50. I've stopped smoking (about 1 year no smoking), drink plenty of water, lost about 30 lbs thus far, take vitamins, sleep enough...doing everything I can to be healthy. But there's still no improvement! I'm thinking they are allergy or weight loss related. Creams do nothing. I have struggled with hormone issues.

Doctor Answers 11

Genetic eye bags can manifest at different ages, but can be treated for the long-term as if you never had them

Thank you for your question. I understand you’re 30-years-old and concerned about the sudden appearance of under eye bags. You state you’ve been trying to live a healthier lifestyle — taking vitamin supplements, quitting smoking, staying hydrated, and losing weight — though none of these helped improve the appearance of your eye bags. You also state your mother also has eye bags, which she didn’t get until she was 50-years-old.
I understand your frustration with your eye bags, and it’s definitely a very common issue that affects many people of all ages and ethnicities. To first give you a little about my background — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. Eye bag surgery is easily one of the more popular procedures I perform in my practice, so I can certainly help you with your concern.
More often than not, there is a family or genetic component in the manifestation of eye bags. In fact, I have operated on three generations within the same family for eye bags. Eye bags do tend to have an aging effect on the face, but the remarkable thing about them is once you address them, it is literally like getting a facelift - suddenly, one’s appearance looks more youthful and less tired.
Under eye bags are caused by lower eyelid fat prolapse, and come about when the fat pockets around the eyes become displaced and push forward. It is important to understand that environmental stressors can play a role in accelerating the progression of eye bags, just as genetics do. For example, you say your mother developed eye bags at the age of 50, but just because she had a later onset doesn’t mean that it couldn’t have happened at an earlier time.
Nowadays, there are a number of different ways to address eye bags, and I think this leaves many people more confused than ever. When I first started my practice 20 years ago, before the advent of many of the non-surgical treatments we have today, eye creams were usually the first method employed against eye bags. When the eye creams failed, which they always did, then people would opt for surgery.
Today there are more options and newer technologies available. In our practice, we address slight under eye bags with the help of hyaluronic acid filler like Restylane, and platelet-rich plasma. This combination, when placed in the area, softens the transition between the under eye bag and the surrounding skin; while the platelet-rich plasma, which is derived from your own blood, improves overall skin quality. In the case of slight under eye bags, the under eye skin usually just needs a little toning up, and the combination of platelet-rich plasma and Restylane accomplishes this very well.
Keep in mind that this method and other non-surgical methods involving radiofrequency devices, only works on slight under eye bags, and not on very prominent eye bags. Injecting filler in an attempt to camouflage prominent eye bags will only cause them to look bigger and puffier, and in some instances can also cause lumps and irregularities. Radiofrequency devices can also cause a certain amount of skin tightening which may benefit slight under eye bags, but there are still limitations to this. Many people make the mistake of being overly aggressive with radiofrequency devices in the hope of tightening the skin enough to reduce the appearance of eye bags, but this only leads to skin damage and volume loss.
That said, to address a case such as yours, I usually perform a procedure called a transconjunctival blepharoplasty. This procedure allows me to approach the fat pockets from the inside of the eyelid to reduce, reposition, and sculpt the fat directly. After the procedure, I usually apply platelet-rich plasma to improve overall skin quality, and depending on your skin type, I would also make use of either fractional CO2 laser, erbium laser, radiofrequency technology, or a non-surgical skin tightening treatment such as Pelleve.
The beauty about a transconjunctival blepharoplasty is it deals with under eye bags definitively, and the results last for a very long time, especially in younger people. Even patients who I performed eyelid surgery on 15-20 years ago will come and see me saying that they feel like they still look great, and that it’s time for me to do injectables or a facelift. There certainly is value in the longevity of the procedure.
Ultimately, I think you’re on the right track in terms of the steps you’re taking to improve your health and the research you’ve done. I advise you meet with qualified and experienced cosmetic surgeons or specialists and learn more about the options I discussed, as well as the type of anesthesia used.
I know many people are hesitant to undergo surgery because they’re afraid of general anesthesia and hospitalization, which is also why they opt for non-invasive procedures. In our practice, we perform all our procedures under local anesthesia with LITE™ sedation, which means that the patient is never completely knocked out, but placed in a calm twilight state of consciousness. Our facilities are approved by the Joint Commission and we combine the facilities of a dermatology office and hospital with the true formality of a skin surgical suite - it really is the best of both worlds. We ensure that our patients recover quickly, they are comfortable, and are well taken care of post-surgery. We’ve been very successful with this type of process and the benefits have been very nice for both doctor and patient.
I hope that was helpful and I wish you the best of luck!
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New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Eye bags

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

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

I suggest you see an expert for treatment this is easily treated with lasers, microneedling, fillers and skin care.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

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Lower blepharoplasty

Consider transconjuctival lower blepharoplasty with fat repositioning. This scarless technique removes the bags while filling the hollow dark circles below the bags. See video and link below.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 61 reviews

Tissue loss

Weight loss and smoking plus genetics contribute to development of lower eye bags.
It is more from a loss of tissue below the eyes that makes the eye bags protrude.
Fillers into this area will provide a pleasing result.
Best wishes,
Dr. Denkler

These measures are not going to have any impact on your eye issues.

I do not think you are ready for eyelid surgery.  However, if you insist on knocking on enough doors, someone will operate on you.  You are missing deep volume in the buckle fat space at the top of the cheek.  Hyaluronic acid filler there and a small amount of volume in the under eye circle will restore the volume you are looking for.  This is likely to work as a solution for you for the next 10 to 15 years.  Find a very experienced injecting cosmetic surgeon who a track record of injecting the under eye hollow.  It is a bit fussy.  You are asking this person to sculpt your face.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Lower lid bags

These can occur at any age depending on your anatomy.  Allergies can make them worse.  You will notice that you have a deep tear trough.  Putting some HA filler such as Restylane into this will help to smooth out the area and decrease the dark circles.  It should last about a year.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Reason why I suddenly got under eye bags...what type of treatment should I look for?

Without examining you it is difficult to be certain but based on the photos it looks like you could have some filler injected into the tear troughs to camouflage them. Eventually you would probably need a lower blepharoplasty to correct things definitively. The only way to know for sure is to book a consultation with a board certified plastic surgeon near you to see what your options are. Best of luck!  

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 21 reviews

Lower Eye Bags

Hi there,

There are multiple reasons for the development of dark circles and lower eyelid bags. You are correct in ensuring you have adequate sleep & nutrients, as this is certainly a variable. Other variables include herniation of eye socket fat, loss of volume in the face, gravity effects, tissue dehydration and stretching of the skin.

Treatment options include minimally invasive procedures such as volume restoration (dermal fillers), anti-wrinkle injections, peels and eye creams. However there is also the option of a Transconjunctival Blepharoplasty. Transconjunctival Lower lid Blepharoplasty involves making the incision behind the eyelid. This is the most ideal procedure for younger patients or those with very little redundant skin on the lower eyelid. The incision is then used to access the prolapsed orbital fat for repositioning or removal.


Thank you.

Angelo Tsirbas, MD
Sydney Oculoplastic Surgeon
5.0 out of 5 stars 1 review

Eyelid Bag

Thank you for sharing your concerns with us. 
The reason why have eye bags as that age is because your cheek bone are not strong. it is a common problem that I see in my practice. Even at this age you will benefit from a blepharoplasty. 
Good luck

Gaby D. Doumit, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 10 reviews

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