In this article:
What are undereye bags?
What causes undereye bags?
How to get rid of undereye bags
It’s a scenario many of us have found ourselves in at one point or another—waking up in the morning, looking in the mirror and coming face-to-face with puffy eyes.
While this is quite common, temporary puffiness, especially when experienced in the morning, isn’t to be confused with true undereye bags. Undereye bags have different root causes than puffy eyes, and it takes more work to improve their look.
So, what exactly makes puffiness different from undereye bags? What leads to undereye bags and are there any eye bag solutions? We’ll lay out the reasons undereye bags develop in the first place and share ways to improve their appearance below. Let’s get into it!
What are undereye bags?
Undereye bags are a stubborn, visible bulge beneath one or both eyes. They tend to feel “squishy” when touched and typically protrude next to the surrounding skin. Most people equate undereye bags to occasional puffy eyes, but as mentioned above, they’re not the same.
Temporarily bloated undereyes can occur at any age and are typically caused by allergies, water intake, diet (too much salt or alcohol, for example) or sleeping position (1,2). This type of undereye puffiness can be helped with undereye bag creams, skin care products and lifestyle pivots. As many have experienced, prolonged bouts of crying can also trigger puffy eyes.
In contrast, true undereye bags tend to occur as we age. The culprit? Fat pads beneath the eyes. With age, these supportive pads begin to shift downward, dropping beneath and protruding from the immediate undereye area. The result is permanent puffiness that won’t go away no matter which skin care-based eye bag remedy you try. Board-certified dermatologist Dr. Corey L. Hartman confirms, saying, “Blepharoplasty (a surgical procedure) is the only effective treatment to get rid of true fat pads causing eye bags.”
What causes undereye bags?
When we’re young, the fat pads beneath the eyes—there are three—are held securely in place. What causes undereye bags is a mix of the passage of time, sun damage and gravity. Together, they cause the ligaments that normally anchor undereye fat pads in place to weaken and push outward, similar to a hernia beneath the skin.
This shifting of fat pads usually happens gradually, but some people experience a sudden onset (3). In some cases, the undereye bags become larger, often bulging out over the top of the cheekbones (a type of eye bag known as a festoon or malar bag) before shrinking back to their normal size. This change in size and appearance is due to fluid retention, such as from allergies, sinus issues or bad habits like smoking—but heredity aspects can play a role. This happens because these undereye bags create pockets where fluid can more likely accumulate, exacerbating this condition.
Undereye bags can worsen when exposed to constant pro-ageing UV rays, which causes further sagging and skin thinning - one more reason to protect the eye-area skin with sunscreen and UV protective sunglasses all year long.
How to get rid of undereye bags
When it comes to fat-pad related undereye bags, it’s important to note that no home remedy can fix them.
As we touched on above, these permanent eye bags—also known as malar bags or malar mounds—are caused by the displacement of fat pads beneath the skin, meaning there is no topical way to address them (4). Even though there are topical skin care products that claim to address this issue, only cosmetic surgery and specific laser treatments can help. Cosmetics for this concern may provide a brief tightening effect via constriction of eye-area skin, but this tactic can backfire since it’s irritating over time.
The specific surgical procedure to fix undereye bags is known as blepharoplasty, which effectively removes undereye bags. Blepharoplasty can be performed on both the upper and lower eyelid areas. If your only concern is bags under the eyes, you would have a lower blepharoplasty (5). In this procedure, a surgeon uses one of two primary methods to access the drooping fat pads and supportive tissue; both methods leave only tiny, discrete scars. In this case, the fat pads are removed entirely, resulting in a smoother, less droopy appearance (6).
In some cases, excess fat and skin are removed before the remaining fat pad is secured back into its original place. For younger patients, it’s typically a much simpler process of repositioning and securing the fat pad to keep it from pouching beneath the eye (7). After a brief recovery period, the undereye bags are gone. We repeat: Gone!
There is also growing research that suggests treating malar bags through hyaluronic acid injection might be a viable non-surgical option, though more studies are needed to establish the efficacy of this technique (8). Dr. Hartman says, “Treatment with hyaluronic acid fillers is used to fill any associated volume loss and can mask protrusion of the fat pad. For some patients, this is a temporising measure to prolong blepharoplasty, but for many it is sufficient to prevent surgery altogether.”
In any case, it’s always a good idea to have a sit-down conversation with your board-certified cosmetic surgeon to determine which solution is best for you to help banish eye bags for good!
Learn more about eye care concerns.
Learn more about our editorial mission.
References for this information:
- Pharmacophore, January 2024, pages 41-47
- SOFW Journal, April 2023, pages 8-12
- Aesthetic Surgery Journal, October 2021, pages 1,107-1,119
- Journal of Cosmetic Medicine, June 2017, pages 1-7
- Seminars in Plastic Surgery, February 2017, pages 46–50
- Aesthetic Plastic Surgery, October 2024, pages 4,310-4,313
- Aesthetic Surgery Journal, May-June 2015, pages 359–366
- Journal of Cosmetic Dermatology, April 2020, pages 820-823