I'm a 39 yr old male with malar bags and look really tired what do you suggest? (photo)

I've got these big puffy bags on my cheek bones, I've been thinking it was from years of sun tanning with no protection, although some one said it could be thyroid? What would you suggest to fix them? Can they be "zapped" off with a deep aggressive laser treatment, or maybe a lower bleph? They are really starting to bother me a lot. The photos are taken with an overhead light.

Doctor Answers 1

The causes of malar bags, options in removing them, why using lasers (heat) may not be a good idea, and improving the tired look

Malar bags are caused by sinuses, allergies and smoking. These conditions drain fluid in an area behind the eyeball called the cavernous sinuses. Through time, they become static at the malar area. If these are not your issuesthat cause the malar bags, then most likely it’s a genetic problem.

When patients who have malar bags come to me, I first assess their face especially their eyes so that I can maximize the improvement of their appearance. Malar bags may have bothered you but you must also observe that you have puffy areas around your eyes. This is called lower eyelid fat prolapse. However, since this is not your concern as of the moment, I could only point that out to you.

A person’s eyes tell so much about how one feels. There is a certain type of non-verbal communication when you look at a person’s eyes. When a person has puffiness under their eyes, they are often perceived as being tired or even old. This has a tremendous impact on the social and work life leading people to look for some type of solution.

The options that have been used for malar bags and festoons are lasers and peels. In my practice, I tend to avoid anything that adds heat to an area. Clinical studies and pathology reviews have showed that there’s fluid in the malar area because of inflammation or inflammatory cells, so interventions where heat is used can actually make the problem worse. Sometimes, the easiest way to treat festoons is to remove them. I’ve also used fillers to try to soften the transition of the appearance of the malar festoons, but because of the complexity of the area, the use of fillers can be frustrating.

I suggest that you take some full faced photos and ask people how your eyes look, not merely focusing on the malar festoons but also look at the under eye bags. If you are motivated, then pursue the things that would yield a more predictable result. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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