Understanding 3 Top Causes of the Loss of Volume & Dark Circles Under the Eyes

Published by Dr. Jay Lucas, MD, a board-certified surgeon with over 20 years of experience.

Key Takeaways

• Under-eye concerns stem from fat loss, skin changes, and genetics — not aging alone.
• Orbital fat loss and shifting create hollows, puffiness, and shadowing.
• Thinner, aging skin reveals blood vessels, darkening the under-eye area.
• Reduced skin elasticity and genetics worsen bags, hollows, and dark circles.
• Treatments include blepharoplasty, fat grafting, and dermal fillers.

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Have you ever had a “helpful” friend or family member volunteer the information that “you look tired”? 

Not very fun, was it? 

Maybe you were already feeling tired, and it didn’t exactly help to have it pointed out. Or maybe you were bubbly and energized — only to find out that your appearance didn’t reflect that. 

If you struggle with dark circles, bags, or hollows under your eyes, you probably know this scenario all too well. That’s because humans look at other people’s eyes to perceive emotions and get visual “status reports.” If we notice puffy eyes, dark circles, or noticeable fine lines and wrinkles around the eyes (all common with age), we assume someone is tired. 

Let’s take a look at some of the primary causes of these very real, very natural under-eye concerns…

3 Primary Causes of Under-Eye Volume Loss and Dark Circles

There’s more than one cause of dark circles, sagging skin below the eyes, or a puffy lower eye area. Aging alone cannot take all the blame, as we’ll see below. To keep it simple (without oversimplifying), here are the three biggest factors causing those pesky under-eye hollows or “bags” that many people acquire over time…

#1. How Orbital Fat Loss Contributes to Under-Eye Hollowing

First (without getting too technical), it can be helpful to know a little bit about human facial anatomy, because the way our anatomy changes over time plays a major role in making our eyes look tired, droopy, and older. 

In medical terms, the space in your skull where your eyeball rests is called the “orbit.” Within and around that orbit, a delicate, intricate collection of muscles, nerves, and fat support your eyeball and play a large role in the appearance of the upper third of your face. 

Typically, while you’re young, orbital fat — the naturally occurring fat all around your eyes — gives your eye area a smoothness and fullness. As you age, some of that fat is lost, while gravity causes some to migrate down below the eyes. This under-eye volume loss is one reason why, over time, a person’s eyes can look more sunken into their face — yet below, there can seem to be an excess of skin and puffiness. 

And what about those dreaded dark circles you find yourself putting more and more concealer on? When the skin around and under your eyes is no longer as smooth because of hollows (sometimes called “tear troughs”) and/or puffy parts, more shadows are cast on that area of your face, causing a darker, more tired look. 

(But dark circles aren’t only a trick of the light! Read on to learn another likely cause.)  

#2. The Role of Skin Thinning and Aging in Dark Circles

As we age, our skin quality changes. Over time, our bodies produce significantly less collagen, our skin’s natural firming agent. This results not only in fine lines and wrinkles but also in thinner skin. 

Here’s how Cleveland Clinic explains this change: 

“As you age, the skin below your eyes begins to loosen and thin out so the blood vessels under your skin may become more visible. This can darken the appearance of your under eyes.”

#3. How Genetics and Skin Laxity Influence Under-Eye Volume Loss

The Effects of Skin Laxity

When we lose volume anywhere on our bodies, we either have extra skin left over, or our skin “bounces back,” essentially shrinking to fit the new size of that area. Our skin’s ability to do this is called “skin laxity.” The problem is…. Yep, you guessed it: our skin laxity decreases as we age. 

So, the older we get, the less our skin can “bounce back” after volume loss. (That’s the loosening skin mentioned by the Cleveland Clinic above.)

That’s why orbital fat loss is a big deal: it leaves us not only with more sunken-looking eyes, but with extra skin that wrinkles, puffs, and so on. 

The Influence of Genetics

It’s a hard truth to share, but another key factor contributing to “tired eyes” is whether the physical characteristics predisposing a person to them run in the family. In short: genetics! If your mother or father struggled with dark circles and bags under the eyes, you likely share similar troubles, too. 

The 3 Most Effective Treatments for Restoring Under-Eye Volume and Reducing Dark Circles

Fortunately, the factors above don’t have the final say about how your eyes look. Let’s talk about solutions!

How Does Blepharoplasty Treat Volume Loss and Eye Bags?

Blepharoplasty (sometimes called eye rejuvenation surgery or eyelid rejuvenation) is a popular and highly effective surgical treatment. Without altering your unique features, blepharoplasty can enhance the natural beauty of your eyes and reduce the appearance of sagging eyelids and excess skin. 

Here’s how Dr. Lucas does it: 

For lower eyelid surgery, Dr. Lucas makes an incision inside the lower eyelid to access and reposition or remove excess fat pads. The incision is made at the junction of the lower lash line and the skin, where it remains well concealed. Then, he delicately closes the incisions for smooth healing.

The results? Smoother, firmer, brighter-looking eyes! Patients typically experience long-lasting results, and with proper care, a refreshed appearance can be maintained for many years.

Fat Grafting for “Tear Trough” Correction

Remember how the loss and redistribution of fat in the orbital area contribute to sunken and yet somehow also puffy eyes? 

Here’s another way a highly-experienced, board-certified plastic surgeon like Dr. Lucas can treat “tear troughs”: fat grafting. This trusted technique involves taking excess fat from one area of a patient’s body, processing it, and injecting it into targeted areas to restore volume, firmness, and youthful smoothness. 

The Benefits of Dermal Fillers to Treat Under-Eye Volume Loss

For patients looking for non-surgical treatments, sometimes dermal fillers may offer a minimally invasive, less expensive route. 

For those with mild under-eye hollowness, a soft-tissue filler like JUVÉDERM® Ultra Plus XC may be helpful. It can gently restore volume in the under-eye region, especially for those who have a recessed midface or lack cheek projection.

Unlike some fillers, JUVÉDERM® Ultra Plus XC provides a soft, natural look without adding excessive bulk. However, for individuals with more prominent fat pads, surgery is typically required.

Enhancing Patient Outcomes in Eye Rejuvenation Surgery: Dr. Lucas’s Unique Expertise

With over two decades as one of Knoxville’s premier plastic surgery providers, Dr. Lucas is one of the best plastic surgeons nearby to perform your eye rejuvenation surgery. Many patient reviews, numerous testimonials, and real-life before-and-after pictures attest to his excellent patient outcomes. 

But did you know he also has unique training that has helped him master both the science and the artistry of delicate facial surgeries?

This Specialized Training Makes Dr. Lucas Highly Qualified to Perform Eye Plastic Surgery

On top of attending some of the nation’s most prestigious medical centers, before opening his own plastic surgery center, Dr. Lucas spent a year in an extensive postdoctoral fellowship studying and practicing craniofacial and pediatric plastic surgery. He came away with deep knowledge of human (and particularly facial) anatomy. 

With his decades of experience and specialized education, Dr. Lucas is uniquely qualified to help you achieve youthful, natural-looking results you can enjoy for years to come!

How Personalized Patient Care Improves Confidence in Safety & Results

Even beyond his surgical qualifications, Dr. Lucas and our team at The Lucas Center go a step further to put every patient at ease before, during, and after a procedure. We see every patient as a unique individual, requiring personalized care on a timeline that works for them. 

We know that the best results in plastic surgery don’t come from a one-size-fits-all approach. That’s why your personalized consultation will be all about achieving a true understanding of your specific needs and wants, educating you on the process, and answering any questions. 

Next, Dr. Lucas will formulate a customized surgical plan to achieve your desired results. With that foundation, you can proceed with confidence in the safety, skill, and personalized attention to detail involved in your surgery. 

We find this individualized approach provides the best patient experience from start to finish and supports beautiful, natural-looking results that significantly improve our patients’ confidence in themselves. 

If you’re ready to take the next step toward greater confidence, reach out to us for your own personal consultation today!