Causes, Prevention, and Treatment
Nasojugal fat pads are formed when the skin under the eyes loses its elasticity and create a groove under the eyes and between the eyes and the nose. The fat pads under the eyes occupy the groove and form nasojugal fat pads or under-eye bags.
Figure 1 – Nasojugal fat pads are most clearly seen as raised ripples of soft tissue below the lower eyelid and above the nasojugal line indicating where it ends.
Why Do Nasojugal Fat Pads Affect Facial Aesthetic?
Nasojugal fat pads make your face look puffier and more swollen, even if you are a skinny person. The condition worsens if you have dark circles around your eyes since they make the nasojugal fat pads look more prominent.
Nasojugal fat pads make faces look tired all the time. It is cosmetic in the first place, but it may be a sign of a serious underlying health condition.
What Causes Nasojugal Fat Pads?
As we age, the skin and muscles of our faces become weaker. Our skin loses its elasticity and strength due to the breakdown of elastin and collagen.
The skin under the eyes is sensitive and delicate. The fat finds its way through weak muscles and saggy skin and occupies the area between the eyes and nose creating nasojugal fat pads. (1)
Prolonged lack of sleep weakens the skin and muscles of the face because it accelerates the breakdown of collagen and prevents the formation of new collagen. After a while, the fat and fluids accumulate under the eyes forming nasojugal fat pads. (2, 3)
Allergies participate in the formation of nasojugal fat pads by stuffing up the nose and forming swelling in the sinus tissues. The fat can occupy the space formed between the nose and eyes making nasojugal fat pads. (4)
Smoking damages the collagen in your face and breaks down elastin, which makes the skin loose. In addition, smoking leads to a lack of sleep.
Heavy smokers have spaces between their nose and the eyes, which can be occupied with fat forming nasojugal fat pads. (5)
Heavy makeup can irritate the delicate, sensitive skin under the eyes leading to its swelling. Not removing heavy makeup completely may lead to nasojugal fat pads in the long run. (8)
Nasojugal fat pads run in some families. If your parents have fat pads or under-eye bags, you may develop them too. (9)
How to Prevent Nasojugal Fat Pads?
People who use neti pots say that they are effective in removing nasojugal fat pads and improving dark circles. A neti pot is filled with a saltwater solution. All the mucus and debris in your nose and sinuses will be removed, which prevents the formation of nasojugal fat pads. (10, 11)
Caffeinated tea bags can be applied under the eyes to tighten the skin under the eyes and improve the blood circulation. This prevents the accumulation of fat in the nasojugal area. (12)
Applying cold compresses can be beneficial for the improvement of the overall appearance of the under-eye areas. Cold compresses are highly recommended for dark circles, under-eye bags, and red eyes since they can constrict the blood vessels, which causes some relief.
Notice that you should use a soft cloth to wrap the compress before applying it to avoid getting the delicate skin under your eyes too cold. (13)
Drink More Water
Water makes about 60% of our bodies. Dehydration is one of the most significant causes of all facial problems including under-eye bags and nasojugal fat pads. Stay hydrated. It is recommended to drink 13 cups of water for men and 10 cups of water for women per day. (14)
Use a Sunscreen
Using sunscreen is essential for people who are exposed to sunlight for a long time per day. Sunscreen protects the sensitive skin under the eyes from the UV rays. Wear a sunscreen that is SPF 30 or more.
Try to avoid the sunrays by walking in the shade and wearing sunglasses and hats. (15)
Remove Your Makeup Completely
After wearing your makeup for a long day, you should remove it completely. Wash your face and use makeup removal products to go to bed without any makeup. When you sleep with mascara or any other eye makeup, you irritate your eyes and their surrounding skin and may develop an infection. In addition, makeup accelerates the aging process and enhances oxidative stress. (16
Elevate Your Head During Sleeping
While sleeping, put an extra pillow under your head to keep it elevated. Some people even use special wedges.
This prevents the fat and fluids from accumulating in the lower eyelids, which creates nasojugal fat pads. (17)
Figure 2 – Fat excision and fat transfer medially. The patient also had an upper blepharoplasty and temporal brow lift. (A) Preoperative. (B) Postoperative.
How To Treat Nasojugal Fat Pads?
If your nasojugal fat pads or under-eye bags are formed due to allergies, antihistamines may be the solution. Some over-the-counter medications such as Benadryl, Zyrtec, or Claritin can be effective, but it is better to consult a doctor before taking any medications. (18)
Creams can hide the appearance of under-eye bags, but creams containing retinol is the key to solve under-eye skin issues. Retinol is essential to produce collagen. Some over-the-counter creams contain retinol, but if your nasojugal fat pads are advanced, you may need a higher concentration of retinol. Pregnant women should avoid retinol and vitamin A creams. (19)
Lower eyelid blepharoplasty is the best cosmetic procedure for nasojugal fat pads. The procedure lifts the lower eyelid and removes any excess tissues under the eyes and between the nose and the eyes. (20)
Microneedling depends on CIT or Collagen Induction Therapy to prevent the appearance of nasojugal fat pads or reduce their appearance. When more collagen and elastin are produced in your face, the skin tightens and the fat stays at its place. (21)
Injectable fillers are a temporary solution for nasojugal fat pads. Fillers are injected around and under the eyes to make the transfer of fats from the nasojugal fat pads to the cheeks smoothly and softly. The procedure does not cause any pain. (22)
Figure 3 – (A) Pretreatment (B) Post‐treatment after 3 days (Concealing of under eye orbital fat pads with hyaluronic acid filler: A case report)
How QOVES Studio Can Help
Our range of skin retouching services can help you hide the appearance of a range of ageing signs among other cosmetic improvements for Instagram, commercial modelling or E-commerce productions.
Have your facial proportion and harmony be analyzed into a comprehensive report and learn about how you can improve your aesthetic.
Have our team of photo editors morph your face into more ideal proportions for a visual look at what can be achieved with surgery, exercise and muscle hypertrophy.
Find A Doctor
We’re working on building a comprehensive directory of approved plastic surgeons and practices near you that show a strong understanding of aesthetic medicine with a proven track record.
1. Nkengne A, Bertin C. Aging and facial changes–documenting clinical signs, part 1: clinical changes of the aging face. Skinmed. 2012;10(5):284-289.
2. Matsui, M. S., Schalka, S., Vanderover, G., Fthenakis, C. G., Christopher, J., Bombarda, P. C., Bueno, J. R., Viscomi, B. L., & Bombarda Júnior, M. S. (2015). Physiological and lifestyle factors contributing to the risk and severity of peri-orbital dark circles in the Brazilian population. Anais brasileiros de dermatologia, 90(4), 494–503. https://doi.org/10.1590/abd1806-4841.20153520
3. Sundelin, T., Lekander, M., Kecklund, G., Van Someren, E. J., Olsson, A., & Axelsson, J. (2013). Cues of fatigue: effects of sleep deprivation on facial appearance. Sleep, 36(9), 1355–1360. https://doi.org/10.5665/sleep.2964
4. Freitag FM, Cestari TF. What causes dark circles under the eyes?. J Cosmet Dermatol. 2007;6(3):211-215. doi:10.1111/j.1473-2165.2007.00324.x
5. Model D. (1985). Smoker’s face: an underrated clinical sign?. British medical journal (Clinical research ed.), 291(6511), 1760–1762. https://doi.org/10.1136/bmj.291.6511.1760
6. Donadon, M. F., & Osório, F. (2014). Recognition of facial expressions by alcoholic patients: a systematic literature review. Neuropsychiatric disease and treatment, 10, 1655–1663. https://doi.org/10.2147/NDT.S65376
7. Goodman, G. D., Kaufman, J., Day, D., Weiss, R., Kawata, A. K., Garcia, J. K., Santangelo, S., & Gallagher, C. J. (2019). Impact of Smoking and Alcohol Use on Facial Aging in Women: Results of a Large Multinational, Multiracial, Cross-sectional Survey. The Journal of clinical and aesthetic dermatology, 12(8), 28–39.
8. Jones, A. L., & Kramer, R. S. (2016). Facial Cosmetics and Attractiveness: Comparing the Effect Sizes of Professionally-Applied Cosmetics and Identity. PloS one, 11(10), e0164218. https://doi.org/10.1371/journal.pone.0164218
9. Cole, J. B., Manyama, M., Larson, J. R., Liberton, D. K., Ferrara, T. M., Riccardi, S. L., Li, M., Mio, W., Klein, O. D., Santorico, S. A., Hallgrímsson, B., & Spritz, R. A. (2017). Human Facial Shape and Size Heritability and Genetic Correlations. Genetics, 205(2), 967–978. https://doi.org/10.1534/genetics.116.193185
10. Piromchai, P., Puvatanond, C., Kirtsreesakul, V., Chaiyasate, S., & Thanaviratananich, S. (2019). Effectiveness of nasal irrigation devices: a Thai multicentre survey. PeerJ, 7, e7000. https://doi.org/10.7717/peerj.7000
11. Principi, N., & Esposito, S. (2017). Nasal Irrigation: An Imprecisely Defined Medical Procedure. International journal of environmental research and public health, 14(5), 516. https://doi.org/10.3390/ijerph14050516
12. Li Z, Wang Q. Ice compresses aid the reduction of swelling and pain after scleral buckling surgery. J Clin Nurs. 2016;25(21-22):3261-3265. doi:10.1111/jocn.13362
13. Li Z, Wang Q. Ice compresses aid the reduction of swelling and pain after scleral buckling surgery. J Clin Nurs. 2016;25(21-22):3261-3265. doi:10.1111/jocn.13362
14. Zhang, S., & Duan, E. (2018). Fighting against Skin Aging: The Way from Bench to Bedside. Cell transplantation, 27(5), 729–738. https://doi.org/10.1177/0963689717725755
15. Gabros S, Nessel TA, Zito PM. Sunscreens And Photoprotection. [Updated 2020 Apr 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537164/
16. Rinnerthaler, M., Bischof, J., Streubel, M. K., Trost, A., & Richter, K. (2015). Oxidative stress in aging human skin. Biomolecules, 5(2), 545–589. https://doi.org/10.3390/biom5020545
17. Kashkouli, M. B., Abdolalizadeh, P., Abolfathzadeh, N., Sianati, H., Sharepour, M., & Hadi, Y. (2017). Periorbital facial rejuvenation; applied anatomy and pre-operative assessment. Journal of current ophthalmology, 29(3), 154–168. https://doi.org/10.1016/j.joco.2017.04.001
18. Foutch, B. K., Sandberg, K. A., Bennett, E. S., & Naeger, L. L. (2020). Effects of Oral Antihistamines on Tear Volume, Tear Stability, and Intraocular Pressure. Vision (Basel, Switzerland), 4(2), 32. https://doi.org/10.3390/vision4020032
19. Mitsuishi T, Shimoda T, Mitsui Y, Kuriyama Y, Kawana S. The effects of topical application of phytonadione, retinol and vitamins C and E on infraorbital dark circles and wrinkles of the lower eyelids. J Cosmet Dermatol. 2004;3(2):73-75. doi:10.1111/j.1473-2130.2004.00070.x
20. Bhoutekar P, Winters R. Blepharoplasty Subciliary Approach. [Updated 2020 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557659/
21. Kontochristopoulos G, Kouris A, Platsidaki E, Markantoni V, Gerodimou M, Antoniou C. Combination of microneedling and 10% trichloroacetic acid peels in the management of infraorbital dark circles. J Cosmet Laser Ther. 2016;18(5):289-292. doi:10.3109/14764172.2016.1157363
22. Goel A, Sethi P. Concealing of under eye orbital fat pads with hyaluronic acid filler: A case report. J Cosmet Dermatol. 2020;19(4):820-823. doi:10.1111/jocd.13097