Puffy Eyes from a Young Age? (photo)

I thought it was because I had late nights but looking at pictures from when I was a child I saw that the puffy eyes were with me then also. At 18 I find it horrible because I'm such a young person with such an old tired looking face. I've tried using makeup, eye creams and cold tea spoons to reduce the swelling but nothing helps. I'm not sure if it's hereditary or allergies but I know I suffer from nasal congestion when I try to sleep. How can I get rid of the puffiness?

Doctor Answers 5

Puffy eyes at 18

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Thank you for your question about your lower lid puffiness..

  • The eyelid puffiness isn't swelling but misplaced fat,
  • a lower lid lift (tranconjunctival blepharoplasty) will correct it, 
  • the problem is inherited and not from age,
  • Fillers may help temporarily - being young, surgery is a better investment,
  • have your breathing checked too - allergies make any eye problem look worse.

Hope this helps. Best wishes.

Hereditary fat prolapse

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You have hereditary eyelid fat prolapse, which is not that uncommon. Although surgery [blepharoplasty with fat repositioning] would be an excellent treatment for you, if you wanted to avoid surgery, you could try injectible fillers such as Restylane or Juvederm or Boletero to help camouflage the contour irregularity along your lower eyelids.


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Eyelid bags and facial rejuvenation

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Puffy eyes can benefit from an outpatient procedure known as a lower eyelid blepharoplasty, which exacts very gratifying results in facial rejuvenation. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Eliminate other possible causes first, but it's likely lower eyelid fat prolapse that's caused by genetics, not age

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I can share with you that in my practice, I’ve had patients as young as 14-years-old who have had bags under their eyes since they were little. Unfortunately, this is a genetic trait especially if you’ve eliminated all the other possible causes like late nights, not enough sleep, allergies, sinus problems and other things. If there is puffiness under your eyes regardless of the time of day or environment or the amount of sleep, then the most probable issue is something called lower eyelid fat prolapse. This means that around your eye, there are these fat pockets referred to as extraconal fat. These fat pockets act like a cushion around the eye. In some people, the fat pockets push forward and creates a bulge looking like under eye bags.

A lot of my patients have gone to different drug stores and tried different types of creams and lotions to try and get rid of under eye bags and of course they don’t work. With your age and skin type, and assuming that you have lower eyelid fat prolapse, I think it’s worthwhile for you to consider lower eyelid blepharoplasty.  This is a big decision so I suggest that you really do your research and meet some doctors before you move forward. What I typically do is something called a transconjunctival blepharoplasty. That means going from the inside of the eyelid, getting into the fat pockets and sculpting the fat pockets so you don’t see the bulging of the fat pockets anymore. That’s a permanent solution that can last long-term for 10 to 20 years especially for someone who’s very young.

Hopefully you would be able to take this information and go further and meet with doctors and consider your options. I wish you the best of luck and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Get Medical Evaluation First

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I would recommend seeing an allergist or an ENT that also treats allergeries.  Additionally, seeing your primary care MD would be helpful to look at your thyroid to see if there are issues.

Dr. ES

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.