How to treat under eye top of cheek malar bags? (photos)

I have what I think is fluid/malar bags. It's really bad on my right side but hardley noticeable on the left side. I sleep on my right side...wondering if that could be part of the problem? On the right side it looks less like a bag and more like a scar across my cheek. Wondering if this is a filler issue or surgery or laser? Tired of looking tired. Help!

Doctor Answers 7

Malar bags

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There isn't a really easy fix for your issue. However, a bit of filler can help ease the transition between the under eye area and the cheek. It is certainly worth a try. Find a board certified plastic surgeon in your area and schedule a consultation to discuss. Laser skin resurfacing could also help to tighten the skin which would improve how things look.
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Lower lid bags and eyelid festoons/ malar mounds

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Dear Carrie,

It seems that you have a common problem that many face as they age. You have lower lid bags protruding through into the lower eyelid space as well as eyelid festoons/ malar mounds.

They each need to be addressed for the best results.

I've had much success using Lasers to help these conditions. Make sure the surgeon you choose has experience treating this difficult condition. 

I hope this was helpful. 

Malar Bags and Festoons -- Lasers and RF are Best

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Lasers, fillers, and peels work best in this area.  I suggest seeing an expert for a formal evaluation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

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Cheek Lift and Under Eye Fillers

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Significant periorbital fat atrophy. Your cheeks are also loosing some fat specially at the lateral compartment, which then results in your nasolabial FAT PAD falling making the nasolabial FOLD more pronounced. In some cases this will cause an evident nasojugal groove from the inner corner of the eye (medial canthus) towards the cheek. I do not know for sure if this is your problem or if this in fact is thickening of your malar fat pad area. If the deformity is related to descent of your cheek fat compartments, then you would be a good candidate for a cheek lift with fillers. I would recommend Radiesse in your case, because your cheeks are heavy and you need a product with a large G' (pushing force). I would also correct your under eye hollowness with Belotero injections. I prefer Belotero in this area because it attracts less water than other fillers such as Juvederm or Restylane. Hope this was helpful. Good luck!

Under eye bags

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It's a little hard to tell from the photos, but if you also have some fullness in the lower lids or even just some loose skin, it's possible to correct the lower eyelid shape and perform a small cheek lift at the same time. That produces a great overall contour. Injections are also effective if place in the groove on the front of your cheek, but the result is different and injections aren't permanent.

Malik Kutty, MD
Sugar Land Plastic Surgeon

Malar fat pad

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You are seeing the outline of the malar fat pad and the transition from lid skin to cheek skin.  This is a hard thing to treat.  A small amount of filler can sometimes help to fill in the line.  Lower lid surgery can help to elevate the fat pad and change the shadows - but many people frequently still have persistent edema in the fat pad.  Laser resurfacing over the area can sometimes tighten the skin and help with the shadows.  Unfortunately there is no easy fix for this!  

Malar Bags

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Thank you for sharing your case and photos.  Malar bags are a notoriously difficult thing to treat.  In many cases, filler injections will make the condition look worse.  Try to stay away from salty foods and sleep with an extra pillow behind your head.  This will help your body decrease fluid retention.  Some doctors will try lasers, but I find this of limited benefit.  Good luck!

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 34 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.