"The last common cause is really just skin—kind of sagging skin and what we call prolapsed fat because the skin around the eyes is very thin," Brissette says. "As we get older, the skin can become a little bit more stretched, and then the fat, which is usually around the eye, can migrate forward and it can become more apparent. This is usually the kind of puffiness or the bags under the eyes that people really complain about as they get older. And it's really just an aging change around the eyes."
For these cases, she says it often requires surgery to remove, which you can discuss with your ophthalmologist or healthcare professional.