Puffy bags and dark circles under the eye typically suggest you’ve been burning the candle at both ends. But are late nights and little sleep the only reason for eye bags?
Lifestyle factors play a role, but the ageing process, genetic predisposition and environmental factors often contribute. Oculoplastic surgeons are also trained ophthalmologists, so they will understand how eyelid surgery can affect the health of the eye and the clarity of vision. They can rule out any underlying condition, such as thyroid eye disease, that could be causing changes to the undereye area.
What causes bags under the eyes?
Bags under the eyes can mean different things, including loose skin, bulging fat deposits, pigmentation changes and a deepening tear trough, and the cause is often multifactorial.
As we age, loss of collagen and elastin, which provide skin with scaffolding and elasticity, start to deplete, and the skin under the eyes becomes less firm and wrinkles appear. The underlying tissues that support the eyelids also begin to weaken, and the fat that previously made the undereye area appear smooth and youthful starts to push forward. Fluid can also start to pool in the undereye area, further exacerbating this impression of puffiness.
Dark circles can often be an optical illusion due to the way light reflects facial contours. Any swelling can cast shadows under the eyes, but it can also result from a deepening groove at the junction between the upper cheek and under the eye, often dubbed the tear trough. This is caused by the fat pads in the mid-cheek starting to shrink and descend.
Our skin thins as we age, making blood vessels beneath more prominent, and those with darker skin tones are also more susceptible to pigmentation changes under the eyes.
The lifestyle factors causing eye bags we can control
Several factors have been proven to worsen the bags under the eyes:
- Sun exposure: UV rays speed up collagen and elastin breakdown, and the eye area is particularly vulnerable as the skin is so much thinner. Sun damage also causes pigmentation changes as the body must produce melanin to protect the skin. Use a broad-spectrum high SPF every day, whatever the time of year, and wear sunglasses with UV protection when exposing the eyes to the sun.
- Smoking: nicotine is a vasoconstrictor, which means it physically narrows your blood vessels, hampering oxygenated blood reaching where it should be repairing cells and producing collagen.
- Alcohol: alcoholic drinks tend to be high in sugar, and when sugar enters your bloodstream, it produces enzymes that break down collagen and elastin. Furthermore, once the liver metabolises alcohol, it releases toxins that cause tissue to dehydrate. It also affects our ability to sleep properly.
- Sleep: when we don’t get enough restorative sleep at night, our blood vessels dilate, and this is more noticeable under the eyes, causing dark circles to appear. The eyes also tend to become irritated, which leads to inflammation and puffiness.
- Diet: Circulation-boosting antioxidants and hydrating foods are essential and foods rich in minerals that help balance fluids. The most important rule, though, is to avoid a high-sodium diet as eating lots of salty foods causes the body to retain water and tissues to become swollen.
- Allergies: congestion and inflammation caused by allergies can sometimes exacerbate fluid retention under the eyes.
What eye bag treatment would you recommend?
The skin around the eyes is ten times thinner than other areas of the face, so it’s no surprise that any imperfections here are instantly visible. Although they are harmless, bags under your eyes can be distressing aesthetically. Patients often believe that they make them look older, more fatigued, and less dynamic than they feel.
A lower eyelid blepharoplasty is also known as eye bag surgery or eye bag removal surgery, as it’s the most effective approach to removing bags under the eyes and reducing the appearance of dark circles.
Excess skin and protruding fat are removed, and the lax muscles are tightened by making an incision either hidden just below the lashes in the lower eyelids or through the inside of the lower lid, known as a transconjunctival blepharoplasty. The incision is then closed with fine stitches.