Under-eye Bags . . . Begone!

The definitive guide to banishing bags, preventing puffs and smoothing circles.

ImageOur FOF Beauty Gurus see one question more than any other: “What can I do about my undereye bags and dark circles?!” So we turned our puffy eyes to FOF Guru Dr. Sharon Giese, one of New York’s premiere plastic surgeons, and FOF Guru Dr. Cynthia Bailey, a California-based dermatologist with a penchant for finding the products that really work. Together, they gave us a truly fab blueprint for bag banishement–from potions and lotions to plastic surgery.

  • FOF: First of all, what causes undereye bags and puffiness?
    • Dr. Sharon Giese: Bags are caused by fat herniation. That doesn’t sound pretty, but it’s just a weakening of the membranes beneath your eyeball. Your eyeball sits on a sling and some fat for cushioning. As you age, the membranes that hold the fat loosen, and the fat can sag and pooch forward.
    • Dr. Cynthia Bailey: Eye puffiness can also be caused by congestion of your blood vessels, which can occur because of genetics, lack of sleep, illness or just generally being ‘run down.’
  • FOF: Some women appear to actually have dark skin under their eyes.
    • Dr. Bailey: That could be either excess pigment or shadowing. Excessive skin pigment can cause a brown discoloration of the undereye area and is often genetic.
    • Dr. Giese: Shadowing is literally a casted shadow caused when overhead light hits a physical indentation between the eye and the cheek. It happens when the fat starts to sag, as I described above, or when the cheek starts to drop with age, leaving a hollow indentation between the eyeball and the bone beneath it. It’s a shadow, so no matter how much concealer you use, you can’t cover it up.
  • FOF: Okay, so now we know the main causes–can we talk about how to fix them? Let’s start with congestion of the blood vessels…
    • Dr. Bailey: Your undereye circles are a great barometer of your body’s vitality. If you eat well, exercise and get adequate rest, your circles will fade. Also, cut down on salt and MSG to reduce fluid build up in this area.
    • Dr. Giese: And stay hydrated. Your eyes and skin always look better when you’re hydrated.
  • FOF: Are there any products that improve vascular congestion?
    • Dr. Bailey: Replenix Eye Repair Cream is my absolute favorite undereye product–bar none! It has ingredients to improve circulatory issues including arnica, Vitamin K and peptides.
  • FOF: Okay, what do you do about hyperpigmentation?
    • Dr. Giese: That can be covered by a concealer.
    • Dr. Bailey: Yes, and you also want to protect this area from the sun to prevent further darkening. Use a broad spectrum UVA/UVB mineral sunscreen every day. Products with 5% or more of zinc oxide give the most complete protection. My favorite undereye sunscreen is Glycolix Elite Sunscreen which has a whopping 17% zinc oxide and is gentle on the eyes.
  • FOF: Can you actually lighten the skin under your eyes once hyperpigmentation has already occurred?
    • Dr. Bailey: Skin lighteners such as hydroquinone cream, Retin A, AHAs or retinol can help decrease pigment, but they can be harsh and should be used with care around the eye area. My favorite is Replenix Eye Repair Cream because it has just the right amount of retinol for this delicate area. I’ve also seen some people get great results with light treatments (Intense Pulsed Light) which can lighten pigment.
  • FOF: What can you do about shadowing?
    • Dr. Bailey: If your main problem is shadowing, there are cosmetic procedures and plastic surgery that can actually change the coutour of your eye.
  • FOF: Dr. Giese, as a plastic surgeon, this is your area of expertise . . .
    • Dr. Giese: Yes, the general goal when you’re dealing with the lower eyelid is you want to blend the lower eyelid to the cheek. The smoother that transition is, the younger you look. That’s why models are often airbrushed to look like their lower lid blends seemlessly into their cheeks. Plastic surgeons used to treat the lower eyelids by taking out the fat–they’d remove the undereye “pouch” to smooth things out. But now we see that this can make you look very hollow, and you can even end up with a dent between your eye and your ocular bone which causes more shadowing.
  • FOF: What’s the most current procedure?
    • Dr. Giese: More often now I’ll use injectable filler to smooth the area between the lower lid and the cheek. I use hyaluronic acid–typical brands are Restylene and Juvederm–and do several minute injections, directly onto the eye bone. That smooths the transition and the dark circles are gone.


  • FOF: And that’s less invasive that fat-removal surgery?
    • Dr. Giese: Yes. And it allows you to camouflage a little bit of fat herniation or a little bit of cheek descent. If someone has severe fat herniation, I would still take the fat out. Or if someone has really a lot of cheek drop then they’re a candidate for a facelift.
  • FOF: How expensive is the filler procedure?
    • Dr. Giese: I charge $1200 for both eyes.
  • FOF: How long does it last?
    • Dr. Giese: Three to four years.
  • FOF: How do you know if you’re a candidate for fat removal vs. injections?
    • Dr. Giese: You need to discuss that with a good doctor. The undereye injection is a very particular injection and not everyone does it. I would ask to see a number of that doctor’s before-and-after photos to see what result you can expect. Personally, I think it’s best to consult with a plastic surgeon who does injections. If you go to someone who just does surgery, you’re gonna get surgery. If you go to someone who just does injections, you’re gonna get injections.
  • FOF: What is someone like that called?
    • Dr. Giese: Either a plastic surgeon, facial plastic surgeon, or ocular plastic surgeon. “Cosmetic surgeon” is not a medical speciality according to the American Board of Medicical Specialities. You want a Board Certified Plastic Surgeon. Any doctor can say he or she specializes in “cosmetic surgery,” but that’s a real buyer beware.
  • FOF: Are their topical creams that can also get rid of shadowing?
    • Dr. Giese: There’s no magic cream that’s going to do what filler or surgery can do, but the lower lid skin tends to be very delicate and crepy, so you have to have very good skincare. I can use filler, take out the fat, do Botox–everything–but if a woman has dry, dead skin under her eyes, she’s not going to look good. I recommend regular exfoliation, hydration and vitamins for the skin. By vitamins, I mean anti-oxidants–typically some vitamin A, C and E and then a great hydrator to plump it up.
    • Dr. Bailey: Eye creams like Replenix Eye Repair Cream contain ingredients that layer on the skin in a way that fills in wrinkles and crinkles to brighten the appearance of skin so that it throws more light.
  • FOF: Dr. Giese – do you have a specific eye cream you recommend?
    • Dr. Giese: I don’t have a specific cream, but I do recommend dermaplaning around the eye—it’s a very gentle form of skin exfolation so there’s no downtime. I also use a machine called Biophysique to do a preocedure every four week that stimulates collagen production and oxygenates the skin.
  • FOF: What’s on the horizon for treating underye bags and circles?
    • Dr. Giese: The most promising thing I’ve heard of is a new procedure that takes your own blood and concentrates the growth and nutrient factors. Then they nick the surface of the skin under your eye and rub that concentrated factor right in it. It actually stimulates your own collagen and rejuvenates the skin. It’s great for the delicate undereye skin because it’s non-invasive.
  • FOF: How far away is that?
    • Dr. Giese: It’s kind of here. I had it done myself and I’m going to start clinical trials on it within the next few months. There’s not a lot of clinical data to show exaclty how much it’s going to impact the aging, but the science is very good that this is something that will be a trend in the future.
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    0 Responses to “Under-eye Bags . . . Begone!”

    1. Rhonda says:

      any eye machines possibly cheaper ones that will help with eye puffy bags under eyes.any home remedies? or anything. I’ve tried so many things. Not sure if I’m not given long enough. It also seems more on under eye

    2. hewsin says:

      Having a reverse osmosis water filtration system with a water softener helps my skin look better and my skin feels so soft and smooth.

    3. marrobin36 says:

      I’m fortunate that I don’t have bags under my eyes. However, I went into Lord & Taylor to see if I could find something to conceal blemishes on my face. My dermatologist I get something called Dermabase. At least I think that’s the name. It helped. If you have a L&T near you, you might give it a try.

    4. PattyColman says:

      My name is Patty Colman and I am the Beauty Sleep guru here on this fantastic site! One thing that also helps with eye puffiness is to sleep with your head slightly elevated. This prevents fluids that build up at night from pooling underneath your eyes.
      The WRINKLE PREVENTION PILLOW prevents permanent sleep lines and wrinkles and help prevents eye puffiness while you sleep.

    5. barb4318 says:

      I would like to provide you with information about an anti-pigmentation product. Our unique and innovative formulas are developed to effectively lighten the discolored areas of the skin and prevent the formation of melanin in the cells. We achieve this without using harmful chemicals or ingredients. Our products DO NOT contain hydroquinone, which is the key ingredient in competitive brands. Our key active ingredient in our antipigmentation line is a medical grade patented biomimetic peptide, which has been proven scientifically to prevent synthesis of melanin in skin cells.


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