What causes eye bags, puffy eyes, and dark circles under eyes?
The eyeball rests on a small pad of fat which is between the eyeball and the bone of the eye socket. This fat is held in tightly by our eyelid muscles and eyelid skin. As we age, our eyelid skin and muscle become loose or lax. The fat pad pushes forward or herniates against the loosened lower eyelid skin and creates a bulge or bag under the eye or a puffy eye. The bottom of your lower eyelid skin is attached to your cheek bone by a structure called the arcus marginalis. This structure holds the bottom of your lower eyelid tight to the bone so the eyelid does not fall down into the cheek. As the eye bag or puffy eye bulges over the arcus marginalis attachment, a shadow is created beneath the eye bag, and this dark depressed shadow creates the dark circle under the eye. I also call this the arcus deformity, because it is caused by the attachment of the arcus marginalis. The eyelid skin is also very thin, so thin that you can actually see through the skin and see the color of the eyelid m
