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Bags Under the Eyes

DEFINITION

Puffiness or swelling under the eyes, so-called “bags”, happens as we get older. As we age, the skin on the body becomes thinner, including the skin under the eye. More importantly, the skin becomes less taut and the muscles that support the eyelid become weaker while fat moves forward into the lids and undereye area. The presence of this fat makes the area look puffy. A variety of factors can cause fluid to pool under the eyes including weather changes, hormones, salty foods, not sleeping enough, sleeping predominately on your back, allergies, crying, and genetics. Most of the time, bags under the eyes are more of a cosmetic than medical concern. Your doctor will be able to examine you for other signs of a more serious condition. At home, you can try a variety of home remedies including cold compresses, but more invasive treatments are available.

SYMPTOMS
Swelling of the eyelids, bags under the eyelids, sagging skin, dark circles under the eyes, puffy eyes

DIAGNOSIS
Your doctor will take a history and examine you. Your doctor may want to do some lab tests if you have other abnormalities on exam.

TREATMENT
You can start trying to reduce puffiness by using cold compresses at home or keeping your head raised while sleeping. For cosmetic concerns, you will likely talk with a dermatologist or cosmetic surgeon. A dermatologist can do treatments to increase skin tone and tighten skin including laser resurfacing and chemical peels. A cosmetic surgeon may be able to remove bags under the eyes with a procedure called blepharopasty. During this procedure, a small incision is made just under the eyelids then the puffy, fat-filled part of the lower eyelid is removed and the skin below attached to the skin just under the eyelid, bringing the two together with small stitches. Other surgical options include removing extra skin on the upper eyelid, removing bags from the upper eyelid, making lower lids less droopy or removing extra skin from the lower eyelid.

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