How can you treat eye bags?True eye bags are caused by fatty tissue that protrudes through the skin and muscle of the lower eyelid. This fatty tissue does not grow or shrink depending on your body weight, which explains why baggy lids are seen in skinny people as well. The only permanent way of getting rid of eye bags is to remove the fatty tissue and reinforce the skin and muscle of the eyelid. This procedure is called a lower lid blepharoplasty. It is an outpatient surgery that takes about 90 minutes. The operation is performed in a surgical facility under local anesthesia plus sedation (monitored anesthesia care, or MAC). In most cases, the bag can be removed from the inside of the eyelid, avoiding an incision on the skin. However, if the bag is associated with loose, wrinkled skin, then an incision is made under the eyelashes to remove the excess skin and smooth out the eyelid.