Eye Puffiness Due to Insomnia for 7 Years? Hi, I've had lower eye puffiness for the last 8 years. I think it's due to my insomnia. I've been sleeping more for the last 2 months, regular sleeping schedule and at least 7 hours of sleep. Will my puffiness go away or will I need lower eyelid surgery? I'm 31 now and my bags/insomnia started at 23 years old. Thank you for your question! You have had insomnia for a long time and I understand that you are sleeping more recently and this process of these puffy bags started when you were 23 years old and now you're in your 30s and you're asking if the puffiness will go away or whether or not you will need eyelid surgery. Well, in order to understand what this puffiness is, it is to appreciate how much it is present during your normal waking hours and how much it is at present, whether you get a lot of sleep or not sleep or very little sleep. Most of the time, when people come to us, they'll say that no matter how much sleep they get, those bags don't go away. And everyone asks them if they're getting enough sleep. So it's natural to assume that it's related to the insomnia. What these puffy bags most likely represent, based on the photos you submitted, is something called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that's normally around the eye pushes forward and creates a bulge such that the eyes are always looking puffy. So most likely, it's something that you will need some type of surgical procedure. When it comes to eyelid surgery, there are two approaches in the puffy bags below the eyes. One is the Transcutaneous or the incision through the outside of the eyelid and the other is the transconjunctival or through the inside of the eyelid known as transconjunctival blepharoplasty. Based on your age and the photos you submitted, most likely that's what I would recommend. In my practice, I do a lot of eyelid surgery and a lot of younger people like yourself with bags under the eyes, really appreciate when I do this procedure from the inside of the eyelid. This way, when people see you, they have no idea that you had eyelid surgery. And if I had to choose one procedure which has a dramatic impact on one's appearance is the reduction of lower eyelid bags. It literally opens up people's faces, their eyes. It's almost like having a facelift for so many patients. So, what I advice is do some research and meet with a qualified cosmetic surgeon. My bias is that you go to a surgeon who does a lot of eyelid surgery. Look at the doctor's before and after results and be confident with the style so that you feel that you resonate with the doctor. In our practice, we do this procedure under local anesthesia with LITE IV sedation. Again, our patients appreciate that because they are not put under general anesthesia, they don't go to a hospital. We have our own joint commission approved facilities so the level of safety is at the highest level and at the same time, they get just amount of sedation so that they don't remember anything and they're very comfortable and they are able to recover quickly. Typically, our eyelid patient for lower eyelid bags go back to work in a week or even less with very little bruising and swelling. And again, now is a good time to learn about your options. Do some consultations and choose the right doctor to help you with your procedure. So I hope that was helpful and thank you for your question!