Under-eye bags

Under-eye bags are a prominence or bulge that appears on the lower eyelid due to the displacement of the fat that surrounds the eyeball, the retention of fluids or the combination of both factors.

They are a very frequent reason for consultation because they can give an appearance of tiredness, ageing or sadness, even in people who rest adequately.

It is important to differentiate the bags from the dark circles, since they are not the same problem and require different treatments.

Bags can have different causes.

Ageing. Over the years, the tissues that hold the fat around the eye weaken. As a consequence, this fat protrudes forwards and forms the characteristic bags. It is the most frequent cause.

Genetic predisposition. Some people present bags from a young age due to a hereditary component.

Fluid retention. The temporary accumulation of fluid can make the bags more visible, especially on waking, after little sleep, after consuming a lot of salt, after ingesting alcohol or during allergy episodes. These bags usually improve throughout the day.

Skin laxity. The loss of collagen and elastin favours the descent of the tissues and increases the visibility of the bags.

Bags can become more evident due to:

• Lack of sleep.
• Stress.
• Tobacco.
• Excess salt.
• Alcohol.
• Allergies.
• Sun exposure.
• Ageing.

Bags produce a relief or bulge. Dark circles produce a change of colour or a hollowing.

Many people present both problems at the same time.

The diagnosis is clinical. During the consultation, the doctor will assess the amount of protruding fat, the quality of the skin, the laxity, the presence of dark circles, the anatomy of the eyelid and the facial symmetry.

This assessment makes it possible to determine which is the most appropriate treatment.

The treatment depends on the origin of the bags.

Conservative measures. When there is fluid retention, it may be recommended to sleep with the head slightly elevated, reduce salt consumption, sleep enough hours, control allergies and apply cold compresses occasionally. These measures can improve transient bags, but do not correct bags produced by fat.

Medical cosmetics. Some products can improve hydration, the quality of the skin and firmness. They do not eliminate bags caused by fat herniation.

Polynucleotides. They can improve the quality of the skin of the lower eyelid and complement other treatments.

Skinboosters. They improve the hydration and elasticity of the skin of the eye contour.

Fractional lasers. In selected patients they help improve the quality of the skin, the laxity and the fine wrinkles of the lower eyelid. They do not eliminate the protruding fat.

Surgery (lower blepharoplasty). When the bags are produced by fat herniation, lower blepharoplasty continues to be the most effective treatment. It makes it possible to reposition or eliminate the excess fat and rejuvenate the gaze in a lasting way.

The appropriate treatment makes it possible to reduce the appearance of tiredness, rejuvenate the gaze, improve the contour of the lower eyelid and achieve a natural result.

The results will depend on the cause of the bags.

Ageing cannot be avoided completely. However, these measures help delay some changes: use sunscreen daily, do not smoke, sleep adequately, maintain a balanced diet, reduce excess salt, control allergies and maintain a healthy lifestyle.

It is advisable to consult when the bags are permanent, increase progressively, are accompanied by significant laxity, give you a constant tired appearance or you want to know the available treatment options.

• Myth: Bags appear only due to lack of sleep. Fact: The most frequent cause is ageing and genetic predisposition.
• Myth: Creams eliminate bags. Fact: Creams improve the quality of the skin, but do not eliminate bags produced by fat.
• Myth: Bags and dark circles are the same thing. Fact: No. They are distinct problems that can coexist.
• Myth: Ice makes bags disappear. Fact: Cold can temporarily reduce fluid retention, but does not correct permanent bags.
• Myth: All bags need surgery. Fact: It depends on their cause. Some improve with medical treatments or conservative measures.

• Under-eye bags are usually due to ageing and genetic predisposition.
• They must be differentiated from dark circles because they require different treatments.
• Fluid retention can worsen them temporarily.
• Medical treatments improve the quality of the skin, but do not eliminate bags of fatty origin.
• Lower blepharoplasty continues to be the most effective treatment in indicated cases.
• A personalised medical assessment is fundamental to choose the best therapeutic option.