Are Eye Bags Causing You To Look Older Than You Actually Are?

by Dr Wan Chee Kwang
January 13, 2021

Eye bags are pretty common, especially in Singapore where we struggle to get enough sleep. But for some patients, clocking in the hours still won’t cut it. This is because eye bags may be caused by factors beyond our control, such as:

Some people may genetically be prone to eye bags because their bone structure may not be able to support the overlying tissues, resulting in surrounding fat to bulge. Eye bags are especially common in individuals from certain ethnicities.

As we age, we lose collagen, connective tissues in skin, fat padding, muscles and other body parts. Unfortunately, lower collagen levels cause skin and underlying muscles to lose their elasticity, and this sagging is especially prominent around the eyes.

Water retention
Excess fluid can pool in the eye bags, causing the eye bags to look puffy and swollen. Water retention can be caused by insufficient sleep and poor circulation.

Excess fat pockets
Normal fat that supports the eyes can move into the lower lids, causing your eye bags to appear puffy.

Some of my patients who complain of eye bags and dark eye circles often have an underlying history of chronic allergies, such as atopic eczema, allergic rhinitis or chronic sinusitis. Allergies can cause the blood vessels of the under eye to congest, which is made worse by constant rubbing of the eyes. It may be difficult, but please try not to rub your eyes!

Types of eye bags

There are actually different types of eye bag conditions. This is because eye bags often result from a combination of anatomical factors like orbicularis muscle prominence and tear trough depression. Hence, it’s important that your doctor analyse your condition individually not just with 3D imaging but also by feeling and measuring the under eye area. 

Here are three types of eyeball conditions I’ve noticed in my practice:

Type 1

  • Eye bags do not look very prominent, only obvious when you look upwards 
  • A result of mild fats accumulating under the eyes or early loss of medial cheek volume

Type 2

  • Eye bags are visible accumulated fats; form a semi-circle under the eyes 
  • Eye bags are pretty obvious, can be seen if you look straight 

Type 3

  • Eye bags form a semi-circle under the eyes 
  • Very prominent; cause your eyes to look swollen and tired
Eye bag removal

Tired of looking tired?

Eye bags can cause you to look tired and much older. If eye creams and concealers don’t work sufficiently, or if you’re looking for a more permanent fix for the baggage under your eyes, I offer many non-surgical solutions. Let’s get into it! 

Eye bag removal in Singapore


As mentioned previously, we lose collagen as we age, and this has a direct effect on our eye bags. So what’s one way to restore this lost collagen? Inject collagen, of course — and this can be done with fillers. Fillers can be classified into 2 groups: 

  • Volume replacement — these fillers compose of hyaluronic acid, a natural occurring polysaccharide that draws and binds water 
  • Collagen stimulating — these fillers contain materials like calcium hydroxyapatite and polycaprolactone, which help the body produce collagen

For softer areas like the under eyes, I prefer to use fillers that are soft or medium in viscosity.

High Intensity Focused Ultrasound (HIFU)

HIFU works by using a high amount of heat; irreversible cell death occurs above 56 degrees. This HIFU energy focuses on the targeted fat (or eye bag) area, creating a rise in local temperature. This heat causes a two-way effect — permanent destruction of the fat cells and contraction of surrounding collagen, which improves tissue laxity. This method is rather natural in a sense that the body removes the destroyed fat cells by itself. No skin, tissue or organs will be harmed in the process.

Fractional Bipolar Radiofrequency 

I use Fractional Radiofrequency to create a thermal injury zone to tighten the skin and tissues overlying the fat pockets. Compared to regular fractional ablative lasers, I find that Fractional Radiofrequency comes with perks like lesser downtime and lesser risk of post-inflammatory hyperpigmentation. 

Subdermal laser/radiofrequency

A tiny probe inserted under the skin generates laser/radiofrequency energy. This energy is absorbed by the skin and surrounding tissues, thereby stimulating collagen production and contraction to tighten loose skin and reshape any loose tissue.

My customised treatment for eye bag removal

Usually, I prefer to combine treatments to tackle each factor appropriately; because chances are, you have eye bags for a myriad of reasons. So for example, someone with eye bags due to ageing would have a treatment plan similar to this: 

  • Fillers in the cheeks and tear trough for bone support as well as to reduce the protrusion of the eye bag 
  • HIFU or subdermal laser/radiofrequency to reduce any extra protruding orbital fat 
  • Radiofrequency or any fractional energy devices to tighten thin skin pocket and support deeper structures 

This might appear excessive, but there’s no point getting a cheaper and temporary fix only for your eye bags to resurface faster. You always want to achieve longevity in your treatments.


  1. Goel, A., & Sethi, P. (2020). Concealing of under eye orbital fat pads with hyaluronic acid filler: A case report. Journal of cosmetic dermatology19(4), 820–823.
  2. Kołodziejczak, A., & Rotsztejn, H. (2020). The eye area as the most difficult area of activity for esthetic treatment. The Journal of dermatological treatment, 1–8. Advance online publication.

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