Most commonly the puffiness under the eyes is a result of a forward outpouching (pseudoherniation) of the fat that surrounds your eye. \u00a0Normally this fat is contained around the eye (where it\u2019s hidden) by a thin structure called the orbital septum. \u00a0It acts very much like a sheet holding the fat back. \u00a0As we age, this septum becomes thinner and weakens, allowing the fat to \u201cpooch\u201d forward.<\/p>\n
In addition to the bags, with aging and gravitational changes, the volume of your cheeks and midface is being reduced and pulled downward. \u00a0This downward descent of the midface structures leaves a deficiency or hollowing under the eyes, resulting in a \u201ctear trough\u201d (nasojugal groove).<\/p>\n
A lower eyelid surgery called lower blepharoplasty with fat repositioning is available to help combat these issues. \u00a0Lower blepharoplasty is performed through a hidden incision on the inner surface of your eyelid. \u00a0Through this incision the fat that is \u201cpooching\u201d is mobilized and moved to an area where it is useful \u2013 the tear trough, where there is volume deficiency. \u00a0This serves to move fat away from an area of excess and fill the area of deficit, smoothing the contour between the lower eyelid and the cheek.<\/p>\n
![\"Before](\"https:\/\/donyoomd.com\/blog\/wp-content\/uploads\/2014\/03\/BeforeAfterLowerBlephwithFatRepo-1.jpg\")
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