What is the reason for my horrible puffy eyes & dark circles? (Photo)

I am really desperate with these huge puffy eyes and dirk circles and I am just 30 years old. I shame basically every morning to go to the office and I know that people think: This guy must have partied all night. Is a plastic surgery the only help or could it be another reason, allergic etc.? It doesn't matter if I drink or sleep not enough, it is always the same. I would say it gets better during they day, but it will stay at least until late afternoon. I would highly appreciate advise.

Doctor Answers 3

Retroseptal fat

You would benefit from excision of retroseptal fat.  This fat that is around the eye can herniate and cause the puffiness you are experiencing.  There are many techniques to fix this.  Visit with your local plastic surgeon for a consultation.  Best wishes!

Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Cause of puffy lower eyelids

Based on your photographs you most likely have herniation or protrusion of the fat beneath your eyeball which is pushing forward on the lower eyelid and causing the eye bags.  High salt intake and fluid retention can make them appear worse but they are a structural problem that in my experience requires surgical correction.

Modern techniques for removal of eye bags includes a trans-conjunctival blepharoplasty, removal of the protruding fat, grafting of the fat into the depression below the eyelid and a skin tends to remove excess loose eyelid skin.  Please consult an expert board certified plastic surgeon.

Eyes bags that are always puffy are due to lower eyelid fat prolapse. They can be removed with no visible trace of surgery

As a practicing cosmetic oculofacial plastic surgeon for 20 years and having written a book “The Fine Art of Looking Younger”, I can tell you that a lot of young males have similar problems with puffiness under the eyes. I’ve had patients who stopped looking at mirrors because they were always bothered by how much their puffiness under their eyes made them look so tired. There is a lot about the micro expressions of how our appearance communicates who we are, how we feel, and the energy level. Bags under the eyes are often perceived as someone who’s not sleeping enough, partying too much, etc.

The lower eyelid puffiness that’s always persistent is called lower eyelid fat prolapse. Lower eyelid fat prolapse has nothing to do with body fat - it’s a genetic tendency for fat that’s normally around the eyes to push forward and create a bulge. Since it’s a physical volume, topical treatments such as creams, ice, cucumber slices and tea bags don’t work.

In our practice, for a young male who doesn’t have extra skin we usually do a procedure called transconjunctival blepharoplasty. Transconjunctival blepharoplasty is a method of addressing the fat pockets by reducing and repositioning them from the inside of the eyelid. This way, no external scar is seen and the intrinsic natural shape of the eye is retained. In fact, our patients feel that they look younger, their face looks brighter and there’s no way someone looking at them could ever tell that they had surgery. I also caution my male patients also that unlike women who routinely wear make-up, men are just not comfortable in doing any cover up. By avoiding an external incision, they don’t have anything to cover up. You may get a little bit of bruising, yellowing and discoloration for a week but that’s basically it. We focus a lot on quick recovery so we do the procedure under local anesthesia with LITE™ IV sedation.

In addition, it’s routine in our practice to use something called platelet-rich plasma. Platelet-rich plasma is derived from your own blood and has many growth factors that help improve skin quality. It is a great combination with our lower eyelid blepharoplasty or transconjunctival blepharoplasty.

At this point, I think you should meet with cosmetic surgeons and look for someone who has a lot of experience with this type of surgery. Do a lot of research and find a doctor that you click with and trust. Once you meet with the doctor that clicks with you, then move forward with the procedure. I think that you have a great weight taken off of your mind when having the puffiness under your eyes reduced. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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