Under-eye bags: Treatment options

Folklore is filled with temporary fixes for puffy eyes. One of the most popular treatments -- covering the puffy area with frozen tea bags, cucumber slices, or the back of an ice-cold spoon -- may actually provide some temporary relief. "In all these instances," Marmur says, "it's really the cold that is working. It's temporarily taking down the swelling."

Dermatologist Audry Kunin, MD, writes in her book The DERMAdoctor Skinstruction Manual that green tea bags may work particularly well. That's because they contain a natural anti-inflammatory chemical known as EGCG, which, she says, can reduce fluid build-up that contributes to puffiness.

Make up artist and bestselling beauty author Michael Maron says there is also some truth to the rumors that the hemorrhoid treatment Preparation H can help deflate under-eye bags. "It helps tighten and smooth skin on a very temporary basis," he says. "But be certain to use only the cream form, not the oil form, which can make the bags look worse."

Marmur agrees that Preparation H can be a temporary fix. But, she says, use it with caution. "You don't want to get this into your eyes," she says. "So be very careful when you apply it."

If you're looking for a temporary fix that lasts a bit longer, experts say the new injectable wrinkle fillers, such as Restylane or Juvederm, can help.

"The filler is injected just under the puffy area to even out the look and remove the indentation caused by the puff," Antell says. "And then, frequently, Botox is used to smooth out the lines. The overall effect is a younger looking eye." Although it can work for early stage puffiness and bags, Antell says the result lasts only about 8 or 9 months before it has to be repeated -- costing up to a couple thousand dollars each time.

For more permanent results that last up to 20 years or more, Antell says nothing beats a surgical eyelift. This involves inserting a tiny electronic probe directly into the "puff" to melt the fat. "In younger people," he says, "all you may need is the fat melting. If you're older and the skin in this area does not have good elasticity, we also make a tiny tuck just inside or below the lower lash line and pull up the excess skin. The result is a smooth, even, very young looking eye."

The eyelift is an outpatient procedure that Antell says takes about an hour. It requires only local anesthesia and light sedation and takes about two weeks to heal. He does add, though, that many people "can go out with a little make up after 8 days."

Although the cost of an eyelift can be high -- $6,000 or more in some areas of the country -- results are definitely lasting. "I had mine done almost 25 years ago," Antell says, "and it's holding well. So I'm living proof the effects last at least this long."