Under-eye bags are a common problem that can be troublesome for people, both young and old. Younger people with under-eye bags generally have them due to genetics, lack of sleep, dehydration, or lifestyle factors, while older people may develop them as a natural part of the aging process.

Thin or thinning skin under the eyes, and small fat pockets that move into the lower eyelids, cause the under-eye area to appear puffy. Meanwhile, a lack of fat in other parts of the lower eyelids causes dark circles.

What are the treatment options for under-eye bags?

Aside from creams or cold compresses applied at home, which are limited in their efficacy, under-eye bags can be treated with lower eyelid surgery or dermal fillers. 

Lower eyelid surgery (blepharoplasty)

Severe undereye bags can be treated with eyelid surgery on the lower eyelids. During lower eyelid blepharoplasty, fat is repositioned to create a smooth, even contour under the eyes. Slack muscles and supporting tendons are tightened, and excess skin is removed to create a firm, youthful appearance. Eyelid surgery achieves dramatic, long-term (in some cases, permanent) results.

Dermal fillers

While lower eyelid surgery is an effective, long-term treatment for the lower eyelids, dermal filler applied under the eyes by an expert facial plastic surgeon can achieve smooth volume under the eyes, resolving dark circles and balancing puffy bags. The result is a youthful, smooth under-eye area that creates an even line from the lower eyelid to the cheekbone. The under-eye area appears naturally full and balanced with the other facial features. Results last for about nine months to a year.

For patients who want to tighten and improve the skin under their eyes, there are also other options, such as lasers and microneedling. 

Dermal fillers may be a better option than eyelid surgery

While lower eyelid surgery provides the most long-term and dramatic results, dermal fillers are a better option for many patients who do not want to have a surgical procedure. Eyelid surgery is not a particularly invasive surgery, but patients will still experience some facial trauma and resultant downtime.

Fillers, on the other hand, require no downtime and require no incisions. The procedure only takes a few minutes. Results are quite significant, leaving the under-eye area smooth and youthful-looking for up to one year. Artfully done, dermal fillers achieve similar results to lower eyelid surgery.  

It’s important to keep in mind, however, that not everyone is a candidate for under-eye fillers. If your eye bags are severe, or your skin is too loose and thin under your eyes, you may not benefit from fillers. Instead, surgery is likely the ideal option for you. After examining your face and skin, if Dr. Levin determines filler isn’t the right choice for you, she will explain why and talk through your other options.

Resolve your under-eye bags with Dr. Flora Levin  

Dr. Flora Levin is an expert when it comes to the eyelids. She is a board-certified oculofacial plastic surgeon who specializes in eyelid surgery & rejuvenation, such as dermal filler treatments.

As a leading expert in eyelid surgery and rejuvenation of the eye area, Dr. Levin has a deep understanding of the eyes and facial anatomy. She achieves results with both surgical and non-surgical procedures, including facial fillers and skin treatments, to help her patients look refreshed and revitalized.

Because the eyelid area is unique and delicate, it is imperative to work with an experienced expert who will choose the correct fillers and use the proper techniques in order to get the best results and avoid complications.

Dr. Levin most commonly uses a cannula for under-eye filler, as it is less traumatic and safer. She only uses hyaluronic acid (HA) fillers for eye treatments, selecting the HA fillers that have the best properties for use around the eyes. 

To find out more about resolving under-eye bags with Dr. Levin, please call today for a consultation.


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