What Causes Puffy Eyelids?
Puffy eyelids are most often caused by herniation (bulging) of orbital fat (the fat from within the eye socket) that pushes up against the lower eyelid. As we age, the muscle in the lower eyelid weakens, as does the septum (the “net” holding back the fat) and the fat starts to push out against the weaker lower eyelid. In addition, the fat of the upper cheek atrophies and the muscles in that upper area weaken, which causes the cheek to sag. This leaves a concave area between the lower eyelid and the falling cheek, which looks like a line or hollow, above which is the lower eyelid. The convex curve of the lower eyelid, because of the bulging of the fat, becomes accentuated and that makes the eyes look puffy and tired. Finally, some people are born with excess lower eyelid fat – it’s a trait that runs in families. While puffy eyelids also can be caused by water retention, allergies, or sinus infections, these are temporary situations that go away when we address the cause. More rarely, we
