Morning puffiness of the eyes is the result of fluid retention (tissue fluid called lymph), which may be caused by eating too much salty food or consuming excessive alcohol the day before. However, it can also be due to kidney diseases, thyroid problems, or disorders of salt–water metabolism, in which case you should definitely consult a doctor.
Certain allergies, lack of sleep, some medications (especially birth control pills), prolonged crying, and excessive alcohol consumption can also cause puffiness in the eyes. Surgery should not be considered until the underlying cause is clarified. Sagging eyelids may also be congenital, related to ethnicity, or appear without any specific reason. In daily life, drooping upper eyelids, sagging lower lids, and bags under the eyes make people look tired and older.
Eyelid surgery is one of the most frequently performed methods in aesthetic and cosmetic surgery. In fact, during cosmetic surgery training, young doctors usually start with eyelid operations, since they are relatively simple. The effects appear within a week and make the patient look significantly younger. Compared to other cosmetic procedures (such as facelifts or breast surgeries), eyelid surgery is more easily accepted socially and is often seen as a normal practice.
In recent years, eyelid correction for men to address an aged and tired appearance has also increased significantly. Among women, the age for eyelid surgery has dropped to as early as 30, and it is routinely performed as an additional procedure during facelifts. The results of surgery typically last 6 to 8 years, since aging continues. With proper skincare and specialized eye creams, this duration can be prolonged. The most effective method against eyelid sagging is surgery, as eye exercises or injections do not provide significant improvement.
Non-surgical treatments like Thermage (radiofrequency skin tightening) have been tried, but results were often unsatisfactory and temporary, lasting only one to two years while requiring significant costs. For wrinkles and fine lines around the eyes, creams, laser treatments, chemical peels, and Botox can reduce their appearance. However, these fine wrinkles cannot be completely eliminated with surgery either, so using creams before and after surgery is beneficial.
For patients who do not want surgery, a combined approach to non-surgical eyelid aesthetics may be applied, including creams, chemical peels, lasers, radiofrequency treatments, and, if necessary, surgery together. In my opinion, surgery remains the most successful method, but it is important to understand that it is not a permanent solution. Since aging continues, eyelids may sag again after 6–7 years, although this period can be extended with proper creams and care.
