The first thing to determine is what kind of puffiness you're dealing with. If it's an around-the-clock situation, the swollen look is likely due to the presence of fat pads under the skin, which can be hereditary and require surgical removal. But if the scourge of under-eye puffery comes and goes, it's likely due to water retention (thanks to crying, hormonal changes, lack of sleep, and other temporary causes) and can be minimized far less invasively.