The Eyes Have It

How to Treat Undereye Bags and Dark Circles

Article by Westport Lifestyle Magazine with Flora Levin, M.D.

Originally published in Westport Lifestyle

Westport Lifestyle Magazine: Let’s talk about undereye bags and dark circles. What causes undereye bags

Flora Levin: Undereye bags are caused by bulging of fat that we all have in our eye sockets. In some people, the tissues that hold that fat inside are either structurally loose or become loose with age, and the fat herniates. 

WLM: Do most people with eye bags also have dark circles? 

FL: It is very common for the two to be present together. The puffiness creates shadowing below it that appears dark. It’s also common to develop volume loss in the tear trough and upper cheek area as we age, further accentuating the darkness. 

WLM: Can bags occur in young people, not just with age? 

FL: Absolutely! I frequently see patients in their 20’s and 30’s that have had bags for as long as they remember. There is no correct age to address the bags, but rather when the person is ready. 

WLM: Speaking of correction, what are the options for someone with eye bags? 

FL: In someone with true fat herniation the options are primarily surgical. Surgery not only eliminates the bags, but also improves the hollows and dark circles. 

WLM: How does it accomplish that and is it a difficult recovery? 

FL: The surgery is called a lower blepharoplasty. I use an advanced technique called fat transposition to achieve the most natural and long-lasting results. Think of the bag (fat) as a speed-bump and the hollow as a pothole. The excess fat is shifted from the speed-bump into the pothole, creating a flat road. The surgery is done through an incision inside of the eyelid, so there is no scar. The recovery is 1-2 weeks, depending on the patient.

WLM: How long do the results last?

FL: The longevity of the results depends on the age when it’s done. In young patients, it’s an anatomical issue, not a result of aging. It is possible that in 20-30+ years, they may need to repeat it, if they develop bags. In older patients that have bags due to age it often lasts their lifetime. 

WLM: What is the most satisfactory aspect about doing a lower blepharoplasty? 

FL: That’s easy! Restoring confidence! The patients look refreshed, not tired, but completely like themselves. Like someone took an eraser and the bags were never there. 

Flora Levin MD, FACS 

Flora Levin MD, FACS 


1391 Post Road East 

Westport, CT 06880 

(203) 557-6474 

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