Lower eyelid bags or puffiness under the eyes is typically due to protruding fat which can lead to a tired or unrested appearance. The majority of the time, light hits our face from above and therefore this fat casts a shadow leading to the appearance of a depression or dark circle. There are two ways to address this issue.
If there is minimal fat protrusion and not too deep of a depression, filler such as restylane or juvederm can be used to fill this depression to the level of the fat, eliminating the dark circle and improving the appearance of the lower eyelids. This typically improves things by 40-50%. Recovery after filler to the lower eyelids is 1-2 days. Of course this is temporary and the filler dissolves after 6-12 months.
The other option is lower eyelid surgery or blepharoplasty. In this eyelid procedure, the fat is teased out and removed but can also be moved into the depression or tear trough. Recovery is 8-10 days and the results can last up to 10 years if not permanently. If there is significant excess skin to the lower eyelids which is redundant, this can also be trimmed at the time of surgery.
Dr. Funk performs lower eyelid bags surgery on a regular basis in Houston.