Under-eye bags are a common cosmetic concern, often linked to aging, fatigue, or lifestyle factors. While you may explore dermal fillers as a quick fix, it’s important to understand that not all under-eye puffiness can be addressed with injectables. The right treatment depends on the underlying cause — and in many cases, surgery offers the most lasting, natural-looking solution.
Dr. Marco Ellis is a board-certified plastic and reconstructive surgeon in Chicago specializing in both non-surgical and surgical facial rejuvenation. In this blog, he discusses what contributes to your under-eye concerns and what type of treatment plan best suits your anatomy and goals.
What Causes Eye Bags?
Eye bags can form due to a variety of reasons, including:
- Fat herniation: As the supporting structures around the eyes weaken with age, orbital fat can protrude forward, creating visible puffiness.
- Volume loss in the midface or tear trough: A hollowed area below the bag can create a shadow, making puffiness appear more pronounced.
- Skin laxity: Loose or thinning skin under the eyes can accentuate the appearance of bags.
- Fluid retention or allergies: These can cause temporary swelling but usually resolve on their own.
Knowing the root cause is usually key to selecting the appropriate treatment.
Why Filler Isn’t Always the Answer
Hyaluronic acid fillers are often used to smooth the transition between the lower eyelid and cheek, especially if you are a younger person with mild volume loss. However, fillers may not be effective, or may even worsen your appearance, if:
- The puffiness is caused by significant fat herniation
- Skin laxity or thinning is present
- Previous filler has migrated or created a puffy, overfilled look
In these cases, adding more volume won’t solve the problem and can lead to an unnatural or swollen appearance.
When Lower Eyelid Surgery Is More Appropriate
If you have moderate to severe eye bags caused by fat protrusion or skin laxity, lower blepharoplasty (eyelid surgery) is often the most effective solution. This procedure removes or repositions excess fat and tightens your skin, restoring a smoother and more youthful appearance. Dr. Ellis uses advanced techniques to minimize scarring and preserve natural eye shape.
Get Expert Evaluation with Dr. Ellis
If you’re unsure whether filler or surgery is the right option for your under-eye concerns, a consultation with Dr. Marco Ellis can provide clarity. With his nuanced understanding of facial anatomy and aesthetic balance, he can guide you toward the safest and most effective treatment. Contact our office in Chicago, IL at (312) 695-6022 to schedule your appointment.