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Symptoms and Causes of Moon Facies. Moon facies may cause the face to gradually become round, full, or puffy. The sides of your face may become so round from the buildup of fat that the ears can't be seen from the front of your face. Fat deposits in the sides of the skull can also make the face look rounder.
The simplest cause of puffiness is simply the pressure on your face while you sleep hours, especially if you don't turn much in your sleep. This will naturally go away as you wake up, but you can help the process by applying a cool, wet cloth to your face. Other common causes are: 1  Water Retention: The most common reason for a puffy face in the morning is fluid retention. The best way to avoid this is to limit alcohol and salt (sodium) intake and, perhaps counter-intuitively, drink more water to flush out the system. Allergic Reactions: A common cause of puffiness in the morning is an allergic reaction.