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Does smoking cause eyelid bags?

Does smoking cause eyelid bags?

A recent study published in the November issue of Plastic and Reconstructive Surgery revealed smoking tobacco can not only make you look older by hastening the number and depth of wrinkles, but also cause premature eyelid bags, excess upper eyelid skin, and darken the lower eyelid skin (i.e.,  cause “dark circles”).

The results were obtained by researchers who evaluated identical twins and their smoking history.  Remarkably, the researchers were able to find identical twins where one twin had a smoking history while the other twin enjoyed a tobacco-free lifestyle.  All other lifestyle choices, experiences, and exposures were essentially the same, so the impact on their facial aging was smoking induced.  When the twins were evaluated closely it was determined that the twin who smoked had worse eyelid bags, more upper eyelid skin, deeper naso-labial folds, larger jowls, more upper lip wrinkles and a trend toward darker skin (“circles”) around the eyes.

These results may not be too surprising because it has long been known that smoking breaks down essential collagen fibers in the skin, leading to earlier and more etched wrinkles and folds.  However, this study lends support to the idea smoking also weakens structures around the eyes causing eyelid bags to become exposed, and additionally leads to the creation of excess eyelid skin, which promotes a tired, sad appearance.  The first remedy to these aging related changes is, of course, to stop smoking.

Although stopping smoking will slow down the tobacco induced aging processes, other measures are needed to reverse the effects and restore a more youthful appearance.  Although cosmetic surgery, including facelifts and eyelid rejuvenation procedures will correct a significant portion of the smoking related changes, patients typically have to stop smoking before these procedures are undertaken.  In the meantime, Botox and other non-surgical treatments such as fillers (e.g., Juvéderm, Radiesse, Belotero, and Restylane) can be used to correct the wrinkles and folds.  Eventually, laser resurfacing using the Active Fx Co2 laser will be needed, which will have a profound impact on eliminating the lines and wrinkles created by smoking.

Two interesting facts:

1.     The researchers found the twins for the study at the annual Twins Day Festival, in Twinsburg, Ohio.

2.     Identical twins have also been used to prove the anti-aging effects of Botox.   In the study, the facial features of the twin who used Botox were compared to the twin who never had Botox injections.  The twin had used Botox for 14 years.  Evaluations revealed the twin who used the Botox had significantly less lines and wrinkles and better skin compared to her sibling, even when the Botox had completely worn off.


Timothy R. Miller, M.D.

One Response to Does smoking cause eyelid bags?

  1. Sohail says:

    Hey Beautiful Lady! I am 49 and looking at hainvg surgery in the new year, I cant thank you enough for posting this video as I have been wondering about the loose skin especially as Im older.

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