24, male - Are these festoons/malar bags/mounds? (Photos)

Question

I noticed for a little while I have these reddish things below my eyes, sometimes it is very noticeable and sometimes it isn't but I just learned that it could be a festoon or malar mound/bag - could someone please help and advise? I don't want them to get worse or have them in the first place lol - is it just from me not getting enough sleep?

Anna Chacon, MD, FAAD · Answer

Thank you for your question and detailed observation.

At age 24, it’s not uncommon to notice changes under the eyes, especially if you’re paying close attention to your appearance. From your description, here’s a breakdown of what may be going on:

What You Might Be Seeing:
Malar Mounds: These are small, soft swellings over the cheekbone area, just below the lower eyelid. They can be congenital (something you’re born with) or develop over time due to fluid retention or fat pad shifts.

Festoons: These are more advanced forms of malar mounds that involve loose skin and muscle and are typically seen in older patients.

Transient Puffiness: Since you mentioned the puffiness varies and can become reddish, it may be related to:

Lack of sleep

Allergies or sinus congestion

Salt intake or hydration levels

Fatigue or eye strain

Why It Changes:
Malar mounds and under-eye puffiness can become more prominent with fluid retention, lying flat for long periods, or inflammation.

If it appears worse in the morning and improves during the day, that’s a classic sign of fluid-related swelling, not structural festoons.

What You Can Do:
Lifestyle Support:

Get consistent, high-quality sleep.

Reduce salt intake and stay well-hydrated.

Manage allergies with antihistamines or nasal rinses.

Topicals and Cooling:

Consider caffeine-infused eye creams or cold compresses in the morning.

Use sunscreen daily to protect the delicate under-eye area.

If It Persists:

If the issue continues or worsens, seeing a dermatologist or oculoplastic surgeon can help confirm whether this is a malar mound or festoon, or simply transient edema.

Imaging is rarely needed unless there's a suspicion of structural fat pad shifting.

Final Thought:
At your age, it’s more likely mild malar edema rather than true festoons or mounds. Managing lifestyle factors and monitoring progression is a good first step before considering any in-office procedures.

24, male - Are these festoons/malar bags/mounds? (Photos)

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24, male - Are these festoons/malar bags/mounds? (Photos)

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