Last summer, I found myself crying on a daily basis due to a painful break up. I cried so much that suddenly at 41, not only did I have a broken heart, I’d developed eye bags too. And they weren’t disappearing. They came to life especially when I smiled, which luckily, at the time, wasn’t so often. But there was also an imbalance; my right side had a far more serious eye bag issue. I became obsessed, scouring the Internet as well as interviewing dozens of experts to understand the phenomenon and find solutions, pronto.
Understanding Eye Baggage
No one likes extra baggage. Unfortunately, eye bags seem to be a natural part of the aging process and something we all need to eventually come to terms with. They can be caused by many factors, but generally as we get into our 40s, the area directly underneath our eye – the orbital septum – experiences a loss of muscle. The fat around the eyeball itself herniates out of the eye socket so that the fat pad seems to protrude, explains Carrie Gessler, MSN, ANP-BC, a non-surgical practitioner at Dr. Leif Rogers in Beverly Hills. Meanwhile, the mid face descends – it’s called gravity— and that creates a hollow under the eyes. If you want to know what lies in your future, simply look at your mother or father because eye bags are genetic.
With that said, there are a few ways to combat eye bags, some more drastic than others depending on the extent of the problem.
Ode to Hypnos
While interviewing dozens of cosmetic surgeons and nutritionists, sleep is something that came up over and over again. Lack of sleep can make under-eye bags more prominent while eight hours of sleep allows the body to rest and recharge, leaving eyes to look fresher, brighter, and more awake.
And – news flash – if you are a tummy sleeper or a side sleeper, like me, these positions allow fluid to pool under the eyes during the night. Bummer. Side sleepers may actually notice that the eye they sleep on has a larger bag than the eye on the other side. Hence why my right eye looked worse than my left!
If your bags appear early in the morning but are generally gone by noon, it probably means fluid retention, adds skin care expert Nathan Halsey. “You may be able to reduce their appearance by simply using an extra pillow to elevate their head whilst you sleep on your back.”
Bag the Bags With Diet and Lifestyle
I am a firm believer that diet and lifestyle are a huge part of aging, so there are things you can do to combat the aging process. For starters, drinking water is a must. Fortunately I am not very into alcohol. Those of you who do consume large amounts of alcohol must understand that dehydration worsens your eye bags by making the skin appear dry, thin, and wrinkly. Although that night out on the town may have been awesome, you may see the consequences on your face as a direct result. Eating salty foods also causes the body to retain water, contributing to under-eye puffiness.
Another tip to stave off eye bags is adding chlorophyll to your diet. This green pigment found in algae and plants is instrumental in photosynthesis, allowing plants to absorb energy from light, adds Cecilia Wong, New York City facialist and founder of Cecilia Wong Skincare.
“This powerhouse pigment also eliminates toxins in the body, reduces inflammation and puffiness, and stimulates blood circulation and oxygenation.”
As far as your diet, it’s best to eat organic, which includes grass-fed or organic or wild caught animal protein for collagen production. Avoid processed foods and GMOs at all costs, and avoid medications/drugs unless absolutely necessary.
Finally, if you’re a sun bunny like me, make sure you use a nontoxic sunscreen under your eyes. UV damage can thin the skin and prompt a loss of elasticity, creating wrinkles and fine lines as well as darkening and pigment problems. Keep in mind that most mainstream sunscreens actually increase your risks of cancer because they are filled with crappy chemicals like parabens.
To recap: watch your salt intake, obviously don’t’ smoke, and don’t drink more than 1-2 glasses wine per day, preferably less. Eat real foods, and of course, incorporate regular exercise, which helps keep skin taught; sweating helps you detox and oxygenate your body.
Deeper Than the Skin
Swelling of the lower eyelid can also indicate certain kidney or thyroid conditions, which in my case made sense. I do have a thyroid condition. Eventually, I realized that when I was regularly practicing hot vinyasa yoga, the bags seemed to lessen.
“Puffiness related to kidney problems often appears around the entire eye area, not just under the eyes. There may also be swelling in other areas of the body like the ankles or fingers. If you’re seeing puffiness throughout the body, it’s a good idea to see your physician to rule out kidney problems,” says Joel Schlessinger MD, FAAD, FAACS Board Certified Dermatologist and Cosmetic Surgeon.
In Chinese medicine, dysfunction of internal organs present themselves on the face; and problems around the eyes are believed to be connected to some underlying imbalance, usually involving the kidneys, adrenal glands, and the liver, adds Dr Josie L Tenore M.D., MSc. of FreshSkin.
According to Dr. Tenore, “Well-trained acupuncturists will take a full health history to pinpoint the culprit and then treat the acupuncture points associated with the imbalance, and in doing so will improve the appearance of bags and dark circles. Holistic acupuncturists may also prescribe herbal medicine or micronutrients, such as licorice, angelica, milk thistle, or vitamin K, which will improve the functioning of those organs, bring nutrients to the affected area, and result in improved facial representation of organ function.”
Shellie Goldstein, a licensed acupuncturist and educator with a master’s degree in biology and nutrition also regularly uses cosmetic acupuncture to treat patients who come in complaining of under-eye bags. As she often tells clients, “the puffiness and sagging of many people’s under-eye bags are a symptom of larger imbalances, and using acupuncture we can address those problems. I’ve noticed that if someone has troublesome bags, they also have other issues – indigestion, headaches, or allergies – that are related to the imbalance causing the cosmetic issue.
Also, allergies and sinusitis can cause swelling of tissue and fat around the eyelids, causing dark circles and puffiness. So maybe change out your pillow (especially if it’s synthetic) and make sure to remove your makeup before you sleep – especially if its toxic.
If I had a $1 for every eye cream on the market, I’d be filthy rich. There’s a slew of them but are they simply beauty b.s?
“Many of the eye creams are just hype and simply don’t work,” says skin expert Nathan Halsey.
Many plastic surgeons I spoke to endorse medical-grade brands, often their own. For hydration and anti-aging effects, creams with retinoids, hyaluronic acids, growth factors, and even new stem cell creams are helpful. Here are effective ingredients to look for in an eye cream:
- Retinol or retinyl – stimulates collagen lifts and firms.
- Arnica – Powerful anti-inflammatory, reduces puffiness and dark circles, drains trapped fluid under delicate eye area
- Vitamin C – anti-wrinkle benefits, aid in the synthesis of collagen in skin
- Vitamin E – Anti-inflammatory, anti-oxidant
- Caffeine – Reduces inflammation and water retention
- Hyaluronic acid – Naturally found in the human body, this acid increases skin hydration, boosts skin elasticity, enhances collagen synthesis, and nourishes healthy skin cell growth
While prescription-strength creams do work to improve the situation, there is no supernatural overnight solution. These products may take up to 4-6 weeks before showing optimal results. But the harsher reality is that they oftentimes include ingredients you cannot pronounce let alone should apply to your face.
I opted for the Pomegranate Eyebright Serum by Zatik. It’s a light formula, yet it’s replete with pomegranate extract, rose hydrosol, minerals, such as calcium, magnesium, potassium, antioxidants, and oils, such as Argan, and pumpkin. It’s void of preservatives or fragrances and is made locally in Glendale, California by a husband and wife duo.
If you are on a shoestring budget or are a rabid DIYer, Shane Ellison, author of Over-The-Counter Natural Cures, suggests a raw egg yolk mask. Raw, they are loaded with B-vitamins, choline and fatty acids. Combined, they act as a natural anti-inflammatory and also help reduce redness while strengthening collagen. Simply rub on and let sit for 10-20 minutes then wash away. Tea bags soaked in warm water and placed on your eyes for 10 minutes can also help shrink blood vessels. The tannins in the tea remove excess fluid from the area and give temporary relief.
And finally, a word to the wise: don’t use hemorrhoid cream even though it’s gained a legendary reputation as a remedy. It can irritate the skin around your eyes, and in reality it shouldn’t even be used on your bum either. It contains phenylephrine, pramoxine, and hydrocortisone and if that gets in your eyes, you’ll be sorry. Plus daily use of hydrocortinsone, which is a steroid, will further thin the skin.
This past New Year’s Eve, I found myself at an obnoxious and pretentious club in Hollywood. As I took inventory of the room, I noticed that about 20 percent of the girls had fillers, especially in their lips. It looked so obvious and well, fake.
Yet as I grimaced in the mirror at the site of how tired I looked, I decided that even though I’d guffawed at those Hollywood women months prior, I could no longer stand looking like Petey the pit-bull from the Little Rascals. I was in Hollywood— Land of Smoke and Mirrors—so why not take advantage?
Turns out fillers with hyaluronic acid, such as Juvederm, Perlane, and Restylane have become crazy popular. In fact, according to the International Society of Aesthetic Plastic Surgery (ISAPS), nearly three million people worldwide were injected with hyaluronic acid to fix nasolabial folds, jowls, marionette lines, tear troughs, vertical lines between the eyebrows, and chins.
If you are dealing with a subtle eye bag issue, fillers injected in the tear trough area can be used to camouflage the fat, making you look rested while correcting volume loss, explains Gessler of Leif Rogers. Dermal fillers, such Restylane, can also boost collagen formation over time. But injecting fillers is a highly tuned skill. If the practitioner gets it right, the results can be magical. But if they get it wrong and the materials used to fill the skin get into a blood vessel, it can cause a stroke, blindness, or kill off big patches of skin, the FDA recently stated in a new warning.
If they inject it into the wrong area or put too much, the results are less damaging, but still very upsetting. The botched procedure may actually make the bag look more pronounced or create a Tyndall Effect, which is kind of what happened to me.
I visited a reputable plastic surgeon in Beverly Hills who I will not mention here and was treated very kindly by the doctor. However, because he injected the filler too close to the surface of the skin, it produced a translucent blue discoloration (Tyndall Effect). He also placed too much volume of filler under my right eye, making it look like there was a bulge. It now looked like I had an inner tube underneath my eye.
Needless to say, I was horrified. He didn’t offer to fix it and I now really couldn’t stand looking at myself in the mirror.
Luckily, I found Gessler and she came to my rescue.
“The patient sometimes believes that they are stuck with this problem, and don’t realize they can correct it,” says Gessler who has fixed tons of eyes over the years. “Sometime the procedure is also done using the wrong kind/brand of filler, which attracts too much water to the area, causing a “doughy” look. Patients may believe that it will go down over time, since the filler is temporary. But in my experience, fillers last much longer in this area, and because the skin is thinner around the eyes, the edema resulting from the overfill can last even longer than the filler itself (years).”
These types of fixes take a few visits to correct. First, she injected an enzyme called hyaluronidase to take out the excess filler. Then, she placed Restylane Silk into the correct place to create the right look. I was very pleased with the results – I could smile again sans eye bags!
If you do go down this path, make sure you get a recommendation and deal with an expert. These days many non-specialists, like dentists, are offering these procedures.
About 1 to 2 cc’s is usually enough to fill in beneath the ‘bag’ to smooth out the area. The price is about $550-650 per syringe, and usually you only need one for the eyes.
Laser It Away?
According to Dr. S. Manjula Jegasothy, board-certified Aesthetic Dermatologist of the Miami Skin Institute, if the under eye sagging is solely due to skin laxity, then radiofrequency lasers or Fraxel® are considered gold standard. Pros include minimal recovery time (2 days redness) and natural results as opposed to a surgical eyelift. However it can be costly ($500-$1000), and this procedure may need to be done three times a year.
Also, take into consideration that the effects are only skin deep, adds John M. Anastasatos, M.D., F.A.C.S., Board Certified Plastic Surgeon. Lasers do not change the conditions that cause the eye bags, which include eyelid muscle laxity, loss of tone over time (orbicularis muscle), and eyelid fat pad herniation. The laser affects overlying skin only and tightens it to a very mild degree.
“The other limitation and potential con is that the eyelid skin is the thinnest skin in the body. It is only 7 cell layers thick. Therefore the laser treatment can cause eyelid skin injury, scarring and eyelid contraction that could be very hard to correct. It could also cause corneal injury.”
In regards to this remedy, I really got mixed feedback. Some doctors told me laser would be their first choice while others stated the complete opposite.
Nip and Tuck
If a person truly has “bags,” surgery is really the only solution that will cosmetically correct the problem. Blepharoplasty can also be performed on the upper eyelids for those who have sagging lids.
According to the International Society of Aesthetic Plastic Surgery (ISAPS), there were nearly 1.5 million eyelid surgeries a year worldwide, that’s more than breast augmentations,
It’s done in the doctor’s office in less than 30 minutes.
Eye Spandex and Other Solutions
Neotensil™ is a new product that can be used on the skin to offer temporary improvement. It involves the application of two layers of product that work to reshape the skin and acts much like Spandex does for abdominal fat. Step 1 involves the placement of a reshaping base layer. Step 2 involves the application of an activating layer that cross links with the base layer; resulting in shaping the skin under the eye, and the improvement lasts up to 16 hours for a hefty price tag of around $500 for a supply.
Lipodissolve is slightly more invasive and involves injecting a solution into the fat pad, which essentially dissolves the fat pad. This should be done with extreme caution and can be associated with significant erythema (redness) and edema (swelling) for up to 10 days and may need to be repeated.
Microcurrent is a painless and non-invasive treatment aimed to eliminate dark circles, while reducing puffiness and bags under eyes. This treatment works by stimulating relaxed muscles under the eye area and re-training them to act youthful. According to Cecilia Wong, New York City facialist and founder of Cecilia Wong Skincare , it also removes built up toxins and increases blood circulation and elasticity, immediately firming, tightening, and lifting under eye skin.
Maryam Henein is an investigative journalist, professional researcher, and producer of the award-winning documentary Vanishing of the Bees.
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