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What are eye bags?

Eye bags can affect one’s appearance, making one look more tired and older. The puffiness and swelling of the area underneath the eyes are common as one age. The tissues around the eyes, particularly the supporting muscles, weaken over time. And fluid can accumulate to create more swelling. The skin also becomes loose and thus making everything more apparent.

True under-eye bags are outpouchings of the orbital fat in the lower eyelids.

In the younger population, eye bags are often solely the results of these outpouchings, with or without tear troughs. Whereas in the older population, these orbital fat outpouchings are often associated with lax skin, muscle, and tear troughs, and malar festoons.

Some eye bags, however, are not real. These “fake” eye bags exist, and thus a careful diagnosis of eye bag is critical to the proper selection of treatment options.

One common condition of “fake” eye bags is hypertrophic or enlarged pretarsal muscle under the eyelash in the lower eyelids, often becoming exaggerated when smiling.

Another “fake” eye bags is tear trough deformity. Tear trough is a sunken trough area of volume loss below the lower eyelids. Tear trough is often associated with eye bags.

Another “fake” eye bags are malar festoons, which are localized squishy swelling on the cheek bone below the orbits.

What are the causes of eye bags?

In the younger patients, eye bag is caused by genetically outpouching of orbital fat or the flatness of the cheek bone relative to the orbital bone.

In the older population, eye bags are caused by the weakening of orbital septum and the increasing descent and flattening of cheeks. The orbital septum is a fibrous wall which prevents fat herniation, but as we get old, this wall becomes weaker and allows more and more fat to bulge outward.

What are the treatments for eye bags?