What Causes Water Retention Under my Eyes?

Thank you for your question! There are many factors that can contribute to the appearance of under-eye bags, such as lack of sleep, body hydration, allergies, skin quality and hormones.
In this particular case, it may be that age is the contributing factor that is contributing to the development of the under-eye bags. As we age, the loss of facial volume and soft tissue becomes more and more apparent, particularly under the eyes. As this occurs, the loss of soft tissue around the eye socket contributes to the development and severity of under-eye bags.

The appearance of under-eye bags can be corrected with a lower lid blepharoplasty and fat transposition for a rejuvenated and youthful appearance.

For more information, consult with an expert facial plastic surgeon about which treatment or procedure may be most beneficial for you. Be sure to view the aesthetic provider’s before and after photos to gain a better sense of the results that have been previously delivered in the past. Thank you for your time. Dr. Kian Karimi

Hi Lisa,
That can be a frustrating problem.  To date, I have never uncovered a health condition that directly correlates with malar edema, and I do not recommend routine testing of any sort to look for an undiagnosed problem for the average patient.  I can imagine there are exceptions to this, but I personally do not encounter them in my practice, with the exception of patients who have undergone complex reconstructive surgeries.
My own mental schema of the lower lid and midface likens the complex to a sponge.  Sponges suck up water, and the movements of the face wring that water out and help move it along into the lymphatic drainage system.  The only approach that I have that works is to tighten every layer of the lower lid / midface complex to improve the effectiveness of the "wringing" of the sponge. I tighten the midface, then the lateral canthal tendon, then the muscles that encircle the eyelid, and finally, the skin.  This does not work all the time, but it does a significant percentage of the time.
The fact that there are so many "solutions" to this problem suggests to me that there are no true high percentage fixes with any of the techniques.
Best regards, 
JDW