Malar bags. What can I do? (Photo)

Question

Hi. I'm only 23 and I feel like I look old!! I have a few (very slight) expression lines on my forehead and I also have malar bags. They make me so self conscious. And they are getting worse. I've tried everything, but I'm scared to get work done because I've also seen a lot of bad reviews on malar bag removal etc. I wear sunscreen every single day and When I'm out in the sun for long periods, I reapply sunscreen and wear sunglasses! I don't know what to do.

Chad C. Zatezalo, MD · Answer

Thanks for the photos.  You have mild malar bags, a prominent tear trough, and an obvious lid cheek junction.  As you are young, the first intervention is good skin care.  antioxidants, sunscreeen etc.. In addition, a small amount of dermal filler will go along way in someone lid you.  I also think laser therapy to your skin will help tighten the malar bags.  I am against surgery for you at this point.   Good luck. Dr Z

Trevor M. Born, MD · Answer

Dear kst17Thank you for your questions and photos!  You have a combination of skin color change, malar puffiness and a hollow.  A conservative approach with skin care first , and possibly some form of laser to improve the skin.  My concern is the malar puffiness- which any type of approach with injury may make this worse.With Warm RegardsTrevor M Born MD

Elham Jafari, MD · Answer

Hi and thank you for sharing your question here! Some
people genetically have very deep tear troughs which may extend all the way
down to the cheeks. As your skin laxity is still good, you can take advantage
from filler injections under the eyes (such as Restylane or Volbella) combined
with Voluma injection at the cheeks and junction of the cheek and eyelid and
get the best aesthetic results. Due to the sensitive nature of the procedures,
please make sure to find an experienced physician with great skills in performing
injections in the mid-face area and someone with a holistic and comprehensive
approach to the face rejuvenation. The injection can be done with flexible
micro-cannula to get the best aesthetic results and less bruising. I hope it
helps and good luck!

Adam Scheiner, MD · Answer

Dear 23 year old patient,Although malar mounds and festoons tend to develop later in life, they can be seen in certain families at an earlier age. They can wax and wane and tend to be worse in the morning. The best way to improve them is to have new collagen fibers and elastic fibers fill that area of the face. The body has great abilities to heal itself and when injured it tends to do this. I've had success improving malar mounds and eyelid festoons using lasers. I'll include a link below. I hope this was helpful.

Philip Solomon, MD, FRCS · Answer

You appear to have a demarcation between your lower lid and cheek junction.  Injectable fillers would be most suitable for your case.  You also may benefit from a laser resurfacing of the lower lid cheek junction.

Elliot M. Heller, MD · Answer

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.
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Jason Emer, MD · Answer

A combination approach will give the most improvement. Well-placed fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Philip K. Robb Jr., MD, FACS · Answer

I love taking care of patients your age! There are multiple reasons why I love it (perhaps I wish I would have starting investing in my skin/face earlier ;/) 
1st- you should know that you're beautiful - I see your complaints and those can be treated with minimal intervention. 
forehead lines- botox can easity treat that- some skin care would aid in skin preservation and keeping things glowing and healthy
"malar bags" aren't really malar bags- they are just teh under eye shadows - this can be conservatively treated with some simple filler. 
Some attention to your cheekbones would restore the "young" look that you'd like. 
Find someone who you trust- it's your face- how the world sees you-

Hope this helps and God Bless!
Dr. Robb

Kenneth D. Steinsapir, MD · Answer

I estimate 1 ml of Restylane will do it.  The service really needs to be done by a physician who is also an artist.  You are asking to be sculpted.  Finding that level of care can be frustrating.  I have folks who travel to see me for this service from London and Dubai.  At your age, the treatment is likely to last well over a year.  There are other options but do not get fat grafting, this will mess you up as will most other surgery.  A chemical peel is very useful.  Choose wisely but there is very satisfying help out there for you.

Edgardo Zavala, MD · Answer

Analyzing your pictures what I see is a very significant tear trough that is the result of inadequate volume in your cheeks. An excellent technique to improve this is a filler placed expertly in your cheeks and blend the cheeks into the lower eyelids. The technique I use is called Bioplasthy developed in Brazil since 1992 and uses permanent fillers placed with a cannula deep below the orbicularis muscle and cheek muscles. The results are great and avoid other more invasive procedures. You should consult an experienced surgeon that has knowledge of these techniques. Good luck

Malar bags. What can I do? (Photo)

Answers (19)

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