Is this treatable? Always have had slight bags under eyes (Photos)

Always have had slight bags under eyes, lately i have had swelling under right eye on upper cheekbone. It seems to come and go in size. Sometimes barely noticeable, sometimes a bit puffy. It can feel a little pressure at times. I've noticed it older photos it has been around for a few years. Lately a bit more obvious. Doctor prescribed me a cortisone cream, but it didn't work. I do have all on four dental implants

Doctor Answers 9

Under eye bags

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Thank you for your question.  Based on the photos provided, the swelling under your eyes are due to fluid accumulation.  This can be difficult to treat at times.  See a specialist for an in-person consultation and to learn more.  Best wishes.   

Newport Beach Oculoplastic Surgeon

Malar edema

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Hi. It looks like you have festoons or malar edema (fluid or swelling underneath the eyes). It can be hard to treat. Filler or laser are options. Some physicians have injected doxycycline with some success. An in person consultation can help determine you right best options. Hope this helps. Best regards, Ira Vidor, M.D.

Ira Vidor, MD
Newport Beach Oculoplastic Surgeon

Lower Eyelid Bags

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Your concerns are very common for both women and men.  While surgery is an option, I find that men are far more open to a non-surgical approach.  Fillers work very well under for under eye bags since the problem is the result of volume loss just below the bags and not really the bags or fat pads themselves.  I have provided a link to a set of before and after photos that demonstrates the use of filler for the lower lids in a man with a similar problem.  In that case we used a filler called Bellafill because it is long term and as as guy he said he would not do "maintenance fillers.  I have added a video about filler safety as well.

I hope that helps and if it does please take a moment ot up vote this answer using the top right button labeled report.  Thanks

Best regards. 

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

Lower eye bags and malar festoons are not the same thing

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Lower eyelid fat bags are located higher than what your photo shows and they don't come and go as you describe. Standard surgical procedures are available for these. 

Malar festoons, which is what it looks like you have, are more difficult to treat and no perfect therapy has been described despite trying about every possible treatment from direct excision, liposuction, lasers etc  etc. 

Under eye treatment

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Since the area you are concerned about changes, it is hard to treat effectively.  You may look into possible causes such as allergies.  Laser treatments and microneedling may give you some improvement.  Speak with a plastic surgeon in your area to learn more.

Camille Cash, MD
Houston Plastic Surgeon
4.9 out of 5 stars 36 reviews

Treatment of Festoons

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Thank you for sharing your question. You have festoons which are particularly difficult to treat. Sometimes, laser therapy is somewhat beneficial.  See and oculoplastic surgeon for comprehensive evaluation and discussion of potential options.

Good luck, 

Eye Bag

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Thank you for your question.  An eyelid bag that is lower on the cheek and comes and goes as you describe is not treatable with surgery.  This is most likely fluid that comes and goes.  There are some very good lasers that treat the deeper layers of tissue and don't allow the fluid to build up.  I would consult with an experienced cosmetic oculoplastic surgeon for a full evalutaion and treatment options.

Jessica Lattman, MD
New York Oculoplastic Surgeon
4.7 out of 5 stars 28 reviews

Cheeks and the eyes

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There are many causes of eye bags. Some are shadow issues, some are discoloration issues.  

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat re-positioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Eye bags

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What you  have in the cheek area  are what we call "festoons".

Theses are extremely difficult to fix completely with fillers and even surgery.

Cortisone, as you have learned will not fix the problem.

We can fill gently under the eye area to help camouflage the under bag hollow area.

This has to be done slowly over several visits so as not to increase the area of swelling. The trick to making it look good is to under correct.

Cynthia Stolovitz, MD
Montreal Physician

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.