Cause: Weakening of the layer that covers the fat in the lower lid allows the fat to bulge, or herniate, towards the surface. The fat is not the problem, but rather a symptom. The anatomical problem causing the symptom is that the fat is no longer in its proper location. It bulges towards the surface of the skin and gives the illusion of excess. Very rarely, a true excess of fat is present, and it’s typically seen in younger patients and is related to genetics. Injectable Solution: Fillers such as Belotero, Radiesse, Restylane, Voluma, and Sculptra or fat grafting to build up lost volume and camouflage the bulging fat pad. Laser Solution: Fractional or Ablative Laser Resurfacing will stimulate collagen production can tighten the excess skin. Surgical Solution: Lower lid eye lift, or lower blepharoplasty, with re-draping of the fat to create a smooth contour between the lid and the cheek. Fat removal is done in rare cases where there is true excess. Product Solution: Products with a retinoid and Vitamin C to build collagen and an eye cream for elasticity. Prevention: Unfortunately, most of the changes in the lower lid are hereditary, so you should be very proactive with sunscreen and our recommended skin care regimen.