Understanding eye bags, their causes, and the correct treatment methods.

27 Aug 2025

Say goodbye to sagging eyes and reduce the age of your face

Eye bags are a common cosmetic concern that can impact confidence, whether caused by aging, genetics, or lifestyle factors. Understanding their root cause is key to choosing the most effective solution.

What are eye bags?

Eye bags refer to puffiness or swelling beneath the eyes, creating a tired, heavy appearance. Medically, they result from structural changes in the skin, muscles, and fat surrounding the eyes.

This issue goes beyond aesthetics, it can affect facial expressions, making one appear tired, lifeless, or older than their age. In severe cases, it may even impact vision. Eye bags can occur at any age, from children to adults, depending on the underlying cause. Identifying the correct cause is key to choosing the most effective treatment.

What causes eye bags? Important factors you should know

1. Aging

The most common cause, especially after age 35. As collagen and elastin decline, the skin under the eyes loses its firmness, while the supporting muscles and connective tissues become weakened. Fat that normally rests within the eye socket begins to bulge forward, combined with gravity and age-related changes to facial bone structure, this gradually creates a more visible appearance of eye bags over time.
 

2. Genetics

 Family history plays a key role. If your parents or close relatives have eye bags, your chances of developing them are higher. Inherited traits such as facial bone structure, fat distribution, skin thickness, and a natural tendency to retain fluid beneath the eyes all influence when and how prominently eye bags appear.
 

3. Orbital fat protrusion

The orbital fat cushions and protects the eyeball, normally held in place by a thin supportive membrane called the septum. As the septum becomes lax due to aging and other factors, the fat protrudes outward, causing puffiness under the eyes. Over time, gravity further pulls this displaced fat downward, emphasizing the swelling.

4. Lifestyle

4. Lifestyle Factors : Although age and genetics are primary causes, lifestyle can accelerate the onset. Lack of sleep upsets lymphatic drainage and elevates stress hormones; chronic stress increases cortisol, which breaks down collagen. Smoking damages collagen and restricts blood flow, while alcohol dehydrates the skin and triggers inflammation. These habits collectively degrade skin quality and intensify the appearance of eye bags.
 

Distinguishing between eye bags and orbital fat? 

Many people confuse “eye bags” with “orbital fat”, but they are not the same. Understanding the difference is key to selecting the right treatment.

• Eye bags refer to the visible puffiness, bulging, or wrinkling under the eyes, often caused by a combination of factors such as protruding fat, skin laxity, fluid retention, or inflammation.
• Orbital Fat is one specific contributor to eye bags. This fat normally sits inside the eye socket to cushion and protect the eyeball. When the supporting tissues weaken, the fat can push forward, creating a bulge.
   

Recognizing this distinction is important for treatment planning, as eye bags caused by excess orbital fat are managed differently from under eye bags caused mainly by swelling or sagging skin.

What causes swollen under eye?
 

Eye bags can worsen when swelling is present. If you already have eye bags, swelling can make the problem appear larger and more noticeable. However, swelling is often only temporary; it can come and go on its own; but still points to these underlying factors.

• Lymphatic fluid retention in the tissues.
• Inflammation and poor blood circulation.
• High salt intake, leading to water retention.
• Food or environmental allergies.
• Hormonal changes, especially in women.
   

Effects of swelling on eye bags?

• Makes eye bags appear larger and more prominent.
• Increases heaviness and eye fatigue.
• Impacts self-confidence and overall appearance.
• Swelling can be a warning sign that eye bags require proper treatment, as it may indicate tissue changes affecting normal eyelid function.
   

How to treat eye bags?

1. Home & Lifestyle care

Lifestyle adjustments : Aim for 7-8 hours of quality sleep, stay hydrated, reduce salty foods, and exercise regularly to improve blood and lymphatic circulation.
Protect your skin : Use daily sunscreen and gentle eye creams with retinol, vitamin C, peptides, or hyaluronic acid to improve skin health.
Massage and facial exercises : Lightly massaging the under eye area can promote circulation and reduce puffiness, but be careful as the skin around the eyes is very delicate.
 

2. Medical Treatments

• Fillers injections : Add volume to hollows under the eyes, reducing shadows and creating a more even appearance. However, it cannot remove excess fat or loose skin, and carry significant risks. There are many blood vessels surrounding and within the eye, improper injection can lead to vascular occlusion, tissue necrosis, or even blindness.
• Other non-surgical options : Certain energy-based treatments or lasers may help with skin tightening, depending on your condition.

3. Lower Eyelid Surgery

Surgery is the most effective way to treat eye bags by removing excess fat, tightening skin, repositioning fat, correcting tear troughs, and reinforcing supportive structures. At BEA Clinic, our oculoplastic specialists perform a personalized assessment and select the most suitable technique for each individual to achieve their optimal results.

• Transconjunctival Approach : An incision is made inside the lower eyelid, leaving no visible scar. This method is best suited for patients with minimal excess fat and mild to moderate skin laxity.

• Transcutaneous Approach : An incision is placed just below the lower lash line, allowing for removal of excess fat, tightening of loose skin, and smoothing of wrinkles. Once healed, the scar is minimal or often goes unnoticeable.
   

  In addition to the internal and external eye bag removal techniques, BEA Clinic also offers the following unique advantages:

1. Performed by board-certified eye surgeons with deep knowledge of ocular anatomyand surrounding structures, our surgeons prioritize the highest level of safety and precision in every procedure.
2. We offer personalized treatment planning, recognizing that every face is unique. We analyze each patient’s facial structure and specific concerns to develop a customized surgical plan to achieve their desired results.
3. Our methodology integrates medical science and aesthetics, addressing underlying medical concerns while simultaneously enhancing your natural beauty and harmony with your overall facial features.
4. Following surgery, we offer comprehensive aftercare for one full year. Postoperative care is as important as the surgical procedure. We provide ongoing follow-up appointments and personalized guidance to help ensure the best possible and enduring results.
5. By carefully selecting the most appropriate technique for each patient, we can achieve natural and long-lasting outcomes, providing refreshed results without the appearance of being overdone.
    

Tired of looking like you haven’t slept, even when you have?
Under-eye bags can be stubborn, but the right treatment can make all the difference.

At Bangkok Eye Aesthetics (BEA Clinic) in Asoke, our friendly team of eye surgeons offers free, one-on-one consultations to help you find the best way forward. We specialize in transconjunctival under-eye bag surgery, a gentle technique designed for natural results that last, with your safety and comfort as our top priorities.

📍 Book a consultation via LINE Official : @beaclinic
📞 Or Call : 064-196-3635

Reference:

• Bags under eyes. Retrieved June 18, 2025, from https://www.mayoclinic.org/diseases-conditions/bags-under-eyes/symptoms-causes/syc-20369927