Puffy eyes can be the result of allergies, sinuses and sometimes even diet.  Most frequently, eyes that remain puffy regardless of time of day and for a prolonged period of time are the result of the prolapse of fat under the eyes.  In our practice we perform a procedure called lower eyelid blepharoplasty, under local anesthesia with sedation.  This procedure is done on an outpatient basis and typically takes about one hour.  Patients go home the same day and are back to work in usually less than one week.