Under-eye bags can develop over time. Unattractive and often seen as a sign of fatigue, they weigh down the gaze and tend to age the face. Malar bags, fatty bags... each type of bag requires a specific solution to "erase" them, as they each stem from a distinct mechanism. But how can we distinguish between them? Here are the elements to consider for differentiation.
Under-eye bags: a test to differentiate them.
Summary
Published on October 6, 2022, updated on October 4, 2024, by Stéphanie, PhD, Doctorate in Life and Health Sciences — 4 min of reading
Themes:
The different types of under-eye bags.
We refer to under-eye bags as unsightly deformities in the lower eyelid region. More specifically, it is a protrusion of the lower part of the eyelid. Aging, lack of sleep, high-salt meals, genetic predisposition, medical conditions, alcohol consumption... the causes of swollen eyes can be numerous. There are two types of under-eye bags that can occur:
Malar Pockets/Edema : These are temporary pockets caused by fluid infiltration at the infraorbital rim. Of varying severity, they are very common in this area because the eyelid has a hard time draining lymph due to the insertion of deep ligaments: the dark circle ligament and the malar ligament in its extension. Malar edema can be triggered by smoking, an allergy (food, cosmetic...), after a salty meal, excessive alcohol consumption, by certain myorelaxant effect drugs (ex : benzodiazepines...) or in the morning following a lack of sleep. However, over time, they will stretch the skin and create a permanent skin laxity with the appearance of permanent pockets;
Fatty Pockets : These refer to a bulge caused by the permanent presence of a soft tissue deposit above the malar prominence, between the lower eyelid and the top of the cheek. They are usually due to a herniation of the malar fat under the lower eyelids, a result of an increase in volume of the intra-orbital fat or because it is no longer sufficiently retained by the septum (skin relaxation). It thus slides downwards under the effect of gravity and skin aging, when the supporting tissues sag. The gaze thus changes with the additional appearance of a slight shadow at the level of the dark circles and a drooping eyelid aspect. In some cases, the cause of these pockets can also be genetic. In this case, the bags under the eyes are related to the conformation of the orbit.
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Malar edema, fatty pockets: how to differentiate them?
It's not always easy to distinguish between fluid swelling (malar edema) and fatty bulges (fat pockets). Among the diagnostic characteristics, they are not located in the same place. Fat pockets are located below the dark circles, on the upper part of the cheekbones on the malar bone, and disappear when lying down, whereas malar pockets are located above the dark circles.
There also exists a simple test to differentiate between these two types of under-eye bags. Film yourself, standing upright, facing a mirror while looking upwards:
If you notice that the bags under your eyes are more pronounced and visible, this is due to a prolapse of orbital fat in the lower eyelids;
If, on the contrary, the bags do not increase in volume, it could be a case of edema, and lifestyle, care, and nutrition advice could improve their appearance. Moreover, compared to orbital fat, the fluid in the eyelid does not change much in the upward and downward gaze.
Sources:
SIMON G. J. B. & others. What causes bags under the eyes? Analysis of 114 consecutive patients. Plastic and reconstructive surgery (2005).
McCORD D. C. & others. Malar mounds and festoons: review of current management. Aesthetic Surgery Journal (2014).
