Can a Mid-face lift get rid of my malar bags? I am 30 years old and have noticed that my malar bags are becoming more prominent. They are not festoons but look more like malar mounds. I never had surgery and I've started to do my research on it recently. Is that good solution?
Mid Face Lift for Malar Bags?
Doctor Answers 15
Acculift for malar bags
Malar bags have been one of the hardest areas to address surgically. A midface lift can often improve the area, however it is a big procedure with a lengthy recovery. I have recently been using fillers to lift the cheek ( Juvederm, Restylane, or Radiesse), but I am especially excited about the Acculift Procedure which uses the Accusculpt laser, 1440 nm wavelength laser, to melt the fat and cause tissue tightening. This is a new procedure, so the results are early, but especially promising for this difficult area. Check our website out for more details and pictures of this procedure.
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Midface Lift is Not the Right Procedure for Malar Bags
Many treatments have been used to correct malar festoons ranging from deep laser resurfacing over volume correction to excisions. I certainly would discourage a midface lift for the goal of malar bag reduction. In my opinion, it would be pure luck if it would help.
Surgery usually not an adequate answer for malar mounds or bags
The appearance of fullness below the orbital rim can be either real or relative.
When real, it is usually due to a fluid accumulation. This is why it is often very variable and will change with diet, position you sleep in, and sun exposure. This will often respond to a mild diuretic, sleeping with your head higher, and avoidance of salty foods.
When relative, it is due to a hollow area in the "tear trough" above it. This can be helped by very careful injections of a filler (we use only Restylane in this location) by an experienced injector.
Even extensive surgery seldom helps it long term.
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Malar Bag Correction
There are several options for malar bags...
Of course it is impossible to advise you on the best treatment for your specific situation without examining you but in general early aging changes around the eyes respond to interventions that stress volume enhancement. Some patients will benefit from a fat transposition Blepharoplasty where orbital fat is brought down over the malar prominence smoothing the deflated cheek. Other patients may get by with fillers such as Juvederm or Radiesse. 30 is a bit young for a big procedure like a mid-face lift and it would be the rare patient that age that would not see improvement from a more conservative therapy. I hope this helps.
Malar bags are one of the most difficult problems to treat. The key step is to look at the underlying anatomic cause:
- Muscle excess- The orbital muscle can sometimes create redundancy along the malar area. This is one of the more correctable causes of malar bags can be corrected through a lower lid blepharoplasty.
- Lymphatics- Lymphatics are one of the more common causes of malar bags and one of the more difficult to treat. Sometimes the lymphatic tissues will swell as a result of allergies, thryoid conditions, or other underlying medical conditions. Treating the medical condition, along with positional changes, low sodium diet, and a variety of other lifestyle changes can sometimes improve this area. In addition, there are a variety of procedures which may help to shrink the lymphatic tissue.
- Excess fat- Less common for lower eyelid fat to herniate into the malar area (distinct from lower eyelid area) but possible and correctable cause.
Mid facelift and cheek augmentation can help with malar bags
A mid facelift may help with malar bags, along with cheek augmentation. At 30 years of age, most people do not have malar bags. A mid facelift can sometimes help if performed properly. Malar augmentation can also help. Make sure your allergies are under good control and the malar mounds are not caused from fluid retention from allergies. A low-salt diet would also be helpful because salt intake can affect malar mounds.
A midface lift is not the answer.
These malar bags are the result of fluid collection. They can be improved with surgery to cauterize the area as well as removing tissue. The recovery can be prolonged and the results are not a complete correction of the problem, but improvement.
Lateral cheek lift through extended blepharoplasty incision best for malar bags
The midface lift will not correct malar bags or festoons. I have used various lasers for many years and they have ALWAYS failed.
The only procedure that has worked has been to extend the lower blepharoplasty incision and do a lateral cheek lift-it works, but canthoplasty is also required.
How to treat malar bags
This is the million dollar question, ow to treat malar bags.
I have my own theories (a theory and 25 cents will get you a cup of coffee as they say) about what causes malar bags.
There is an anatomic septum that runs through the cheek. It is not age related, although the bags get worse when tissue from above sags onto the inflexible malar septum.
It often helps to do a cheeklift not at a subperiosteal level, but at a suborbicularis (underneath the eye muscle). I have published a bit on this technique, and while it doesn't 100% fix every malar bag, it does help decompress the sagging due to sagging, edematous tissues onto an impenetrable septum.
Tissues that cause ablative changes must be carefully considered as they can pull down on the lower eyelid as more tightening is performed.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.