I Got Sudden Bags/puffiness Under the Eyes? (photo)

Question

I got sudden bags/puffiness under the eyes about 2 weeks ago, never had it before. I am 32 years old, get plenty of sleep, exercise regularly, am not stressed, and my diet hasn't changed. I have tried cucumbers, cold eye mask/compression, and eye rollers and creams. Nothing works. I am going to my doctor next week to check for allergies. But other than that, do you guys have any other ideas? Any non-surgical ways to fix this cosmetically? How much would that cost and how long is the recovery?

A.J. Amadi, MD · Answer

If it is truly a sudden onset of bags then allergies are a possibility. Other possibilities include thyroid eye disease, though that's more gradual, or volume [water] retention due to kidney problems.

	However, the most likely scenario is a sudden realization of a longstanding and gradual problem. Based on the photo, this looks like classic lower eyelid fat prolapse, however, an in person exam can better determine level of swelling.

Benjamin Caughlin, MD, FACS · Answer

The fact that this has come suddenly does may me think more of a medical problem and I agree with the decision to see your primary MD ASAP to check some labs etc. If it is not medically or allergy related I would treat this with a lower lid transconjunctival blepharoplasty with fat transposition. You are young and you would do well with this procedure.Cost at my practice $ 3,500.Recovering is 2 wks but I prefer patients to prepare for 3 wks. Results are appreciated at about the 2-3 month mark.Hope this helps.Best of luck,DrC

Harold J. Kaplan, MD · Answer

Hi BubbaGump. For a non-surgical solution, we would look no further than a good injector with Restylane in the syringe. This should help to smooth out the area of concern. If this did come on suddenly, it is prudent to get checked for allergies as this can sometimes be the cause.

Michael I. Echavez, MD · Answer

If your doctor determines that there is no medical condition causing the puffiness under your eyes, then there are two main options for improvement. You could have a filler, like Restylane, injected under the bags to help or you could have surgery to remove some of the excess fat that is causing the puffiness. The cost of each will vary from doctor to doctor and the immediate recovery for the surgery would be about a week.

Camille Cash, MD · Answer

If the condition happened suddenly it may be related to allergies or a thyroid imbalance.  If those are ruled out and you don't notice improvement you may consider cosmetic options.  Fillers are a non surgical temporary option to help disguise contour irregularities.  Lower blepharoplasty surgery is a more permanent solution to correct under eye concerns.  See a board certified plastic surgeon near you to learn more.

Michael Zenn, MD · Answer

If this is truly the first time, you likely have some swelling of the underlying eye fat.  This should be self limited and can be caused by many non-serious things.  Give it some time and it should improve.  I often find in my patients that the bags have been developing slowly and one day - BAM! You notice them. Once seen they cannot be unseen!  If they do not resolve, consider a transconjunctival (through the inside of the eyelid) blepharoplasty to remove the bags.Dr. Z

Kaete A. Archer, MD · Answer

Sudden lower eyelid puffiness sounds like allergies.  There are many possible causes including genetics, aging, fluid retention, salt retention, allergies, lifestyle, sleep, alcohol use, and unknown reasons.  In younger patients, the most common causes that I see are allergy, sleep, and alcohol use.  Allergies cause swelling around the eyelids that results in lower eyelid puffiness.  You may notice that the area is worse after eating certain foods or at certain times of the year.  In terms of camouflage options for a mild bag associated with a tear trough deformity/hollowness, my favorite option is a filler.  The filler is temporary and when placed deep and conservatively by an experienced injector, the risk of irregularity or migration is very low.  Fillers are great options for patients who aren't interested in the downtime from surgery and who want an immediate result.  The cost of a syringe of filler varies depending on your area but can be between $500-700+ depending on the type of filler.    I recommend a consultation with your primary care doctor to discuss possible underlying issues that can cause swelling/fluid retention in this area.  Good idea to be evaluated for allergies as you mentioned.  I would wait to do any cosmetic treatments until evaluated by your physician.

Robert W. Sheffield, MD · Answer

Thank you for your inquiry.Based from the case that you mentioned and your current lifestyle, the suddenappearance of bags under your eyes, may possibly be brought about by allergies.Other possible causes of puffiness under the eyes include having little to nosleep, trauma from treatments done in the lower lids, aging, or thyroid eyedisease. However, none of these may be the cause since you mentioned you haveenough sleep and you are still young. Moreover, these causes will notconstitute to the “sudden” appearance of bags. These will more likely developbags under your eyes gradually. 
Having said that, there is alsoa possibility that this is actually an issue, which you did not noticedeveloping. It may even be a problem that has been occurring for a while now. Justbased on the photo that you have attached, this puffiness under your eyes seemlike a fat prolapse on the lower eyelid. But like what I mentioned before thisis only based on the attached photo. A personal appointment with a boardcertified plastic surgeon would be helpful in identifying this. 
Should this be a fat prolapse, it can beresolved surgically and non-surgically. Non-surgical method is via fillers.This is a temporary solution tough. It is inexpensive, but what it does isconceal the bags to show an improved appearance. It does not remove the bags.On the other hand, the surgical method is blepharoplasty. It is pricey and haslonger downtime, but it can permanently remove the bags. Hope this is helpful!

Gerald Wittenberg, MSc, DMD (retired) · Answer

The fullness relates to increased fluid buildup, increased coloration accentuating the area; as well as an early laxity of the the tissue holding back the eyefat from bulging forward. Correction starts with the reduction of salty fluids, ice and one can even sleep more upright. However, these measures do not fully solve the problem and you may have to consider masking the area cosmetically with tissue fillers like juvederm; or trimming the fat with a small surgical procedure.

Amiya Prasad, MD - Account Suspended · Answer

I’m going to first advise you that if there’s truly a sudden onset of puffiness then you should rule-out anything related to the thyroid such as Graves' Disease or thyroid-eye disease, otherwise known as thyroid-related immune orbitopathy. Although you don’t have the classic appearance of someone with Graves' Disease, I advise you to see an endocrinologist and ophthalmologist to check for this sudden onset of swelling.

	What you likely have is called lower eyelid fat prolapse. This means that the fat that’s normally behind your eyes pushes forward and creates a bulge known as herniated fat. Since it is a fat pocket pushing forward, it is impractical to consider any non-surgical options. As a specialist in cosmetic eyelid surgery, I routinely see patients who have tried every non-surgical, do-it-yourself, and over-the-counter product such as cucumbers, tea bags, hemorrhoid creams, and all kinds of topical treatments that don’t work. Also, a certain percentage of people will visit a non-surgical physician like a dermatologist or an aesthetic physician and get injectables. An example is called Restylane that camouflages the bag.  In my experience, I see patients almost every week who come in to have those injectables dissolved. This is because when you have a volume of fat pushing forward and you try to add a volume of hyaluronic acid that attracts fluid to try to camouflage it, you get larger bags.

	Based on your photos alone, I would suggest a surgical procedure called transconjunctival blepharoplasty. In this procedure, the fat pockets that have pushed forward can be reduced, sculpted and repositioned from the inside of the eyelid. By doing that, there is no scar and no one would be able to tell that you had surgery.  In my 20 years of cosmetic surgery practice, I’ve dedicated myself in finding a quick recovery approach. Most of my patients actually get back to work in a few days or less than a week. For example, if somebody had a surgery on a Wednesday, they can go back to work on Monday. Although there is still a little bit of bruising and swelling under the eyes, patients can choose to apply moisturizer, foundation or even wear tinted glasses to camouflage the area.

	We perform this procedure under local anesthesia with light IV sedation, and the procedure is usually done in less than an hour. I recommend finding a cosmetic surgeon who is in the oculofacial field because of the extensive experience in eyelid surgery, and someone familiar with people like you who need a quick recovery.  I hope that was helpful, and thank you for your question.

I Got Sudden Bags/puffiness Under the Eyes? (photo)

Answers (10)