What Treatment Do You Suggest for Puffiness Under Eye and Top of Cheek?

cheek bone to smooth skin area for a younger appearance.

Doctor Answers (8)

Lower blepharoplasty and/or cheek implants

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The puffiness under the eyes is traditionally taken care of with a lower blepharoplasty through a transconjunctival approach on the inside of the lower lid. If the tops of the cheeks are very flat, consideration for cheek implant augmentation should be done. It is important to have a smooth transition between the lower eyelids and skin of cheek for a youthful appearance.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Suggested treatments for top of cheek and under eye puffiness

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Puffiness in the lower eyelid is usually due to pseudohernias of fat which requires removal via transconjunctival or external blepharoplasty approaches, usually.

Puffiness in the cheek (and occasionally the lower eyelid) can be edema fluid and is referred to as malar pouching, festoons or crescents. This is graded as to severity and whether this is static or fluctuant in nature.

Treatment can include dilute deep steroid injections and massage, radiofrequency treatments (monopolar, bipolar, unipolar) direct excision, and extended transcutaneous lower blepharoplasty with cheek lifting, among other options.

However, this problem can be more difficult to treat than the eyelid, so you are forwarned. Consult an experienced eyelid surgeon.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Options continue to increase

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This area has always been a difficult one to address surgically, which is the reason for the numerous types of cheek and mid-face lifts, some of which are fraught with complications, especially in the hands of inexperienced or naive surgeons. Thankfully, the options for malar pads and the lid-cheek junction continue to expand and include fillers, laser liposuction (acculift with the accusculpt laser) and surgery. Which one might be best for you is best dtermined with a face to face consult and discussion of your goals with an experienced surgeon.

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 40 reviews

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Puffiness under eye much easier to correct than festoons

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Puffiness under the eye is much easier to correct than malar crescents or festoons, which occur at the top of the cheek.

If you are a smoker this can contribute to the formation of these swellings, and surgery will not help unless you quit smoking.

There are different causes for these to develop - some are muscle descent, and all approaches to their correction are limited by persistent swelling after the surgery.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Correction of puffiness on cheek bone (Festoons) requires lateral cheek lift

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The puffiness under the eyes on the cheek bone is called a festoon. Standard blepharoplasty to remove eye bags can make the festoon look worse.

I use an incisional blepharoplasty with an external incision and carry the incision out toward the side of the lower eyelid so that I can actually lift the cheek skin to remove the festoon.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Where is the puffy ?

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A photo would be most helpful. What you describe could be due to peri-orbital fat, overdeveloped muscle, or a cheek fat pad called a festoon. All coud be treated with some form of blepharoplasty with different expcetions of cure, but to make a recommendation, you should provide photos. Look at some sites to get an idea of views that are needed, and then submit.

You may use the 3 views of my patient as a guide!

http://drkasden.us/casestudy.cfm?cid=244&id=8

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 45 reviews

Not enough information

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You have to be more specific as to the nature of the "puffiness". Puffiness is not a medica nor anatomical term, but a descriptive one. Fullness is another descriptive term. if transitory in nature, this can be due to heavy salt intake or allergies. If constant or developmental, it can be due to absolute or relative increase of peri-orbital fat around the eyeball or weakness of structure holding in ths fat. Hypertrophis muscle around the eyelid can cause fullness. It can be due to thinning of soft tissues below this fat that produces a hollowness below and relative puffiness above or hypoplasis of the unferlying boney structures. You will need a complete history and examintation to determine what the cause is and what options you have which are too numerous to delineate here, I believe.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

Two different procedures

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Two different treatments:

1. Non-surgical: Injection of fillers will camouflage the deformity but the correction will only last for the duration of the filler.

2. Surgical: redraping of the eye lid fat over the cheek bone and tightening of the muscle and skin.Extension of the dissection into the upper cheek is a must to insure release of the midface and proper position.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 4 reviews

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.