Bags, dark circles, tear troughs – what's the difference?
Under-eye bags
A bulge below the lower lid, most often caused by orbital fat moving forward as the membrane holding it back weakens with age. Bags can also run in families and appear in people in their twenties or thirties.
Dark circles
Darker skin under the eye, caused by pigmentation, blood vessels showing through thin skin, or a shadow cast by a bag or hollow. Surgery does not remove pigmentation.
Tear trough
A groove running from the inner corner of the eye down and outwards, where the lid meets the cheek. A bag sitting just above it often makes it more visible.
Puffiness and festoons
Puffiness that is worst in the morning and improves during the day is usually fluid retention (salt, alcohol, lack of sleep, allergies, thyroid or kidney disease). Festoons sit lower, on the cheekbone, and are not corrected by eyelid surgery.
When does lower eyelid surgery help?
Lower eyelid surgery is the treatment of choice when bags are caused by bulging orbital fat, and when there is lax excess skin on the lower lid. Fat can be removed or moved into the tear trough, smoothing the lid–cheek junction. With good skin quality the operation is done from the inside of the lid, with no skin scar.
Non-surgical options
Aesthetic treatments – such as tear trough filler, laser or skin-quality treatments – can help with mild changes, pigmentation or thin skin. They do not remove herniated fat, however, and a poorly chosen filler can even make a bag more prominent. That is why it is worth finding the cause before choosing a method.
What you can do yourself
- sleep with your head slightly raised if bags are worse in the morning,
- limit salt and alcohol in the evening,
- treat allergies and chronic eye irritation,
- protect your skin from the sun – sunglasses and sunscreen,
- avoid smoking – it speeds up skin ageing.
These steps reduce puffiness but do not remove bags caused by fat herniation.
When to see a doctor
If bags appeared suddenly, are asymmetrical, come with bulging eyes, redness or pain, or swelling affects other parts of the body, see a doctor to rule out thyroid eye disease or kidney problems.
Want to know what is causing your bags? Book a consultation.
This page is for information only and does not replace a medical consultation. Eligibility for any procedure is decided by the doctor after an examination.
