How to improve malar edema? (Photo)

Based on your photos, you appear to have lower eyelid grooves that extends down into mid phase depressions. In our experience, fillers are not terrific at filling in mid phase depressions since they tend to be caused by a malar a cutaneous ligament. I'm sorry that I don't have a reliable treatment for you. The reality is that most people probably don't notice. I hope this helps. Sincerely, Dr. Joseph

It really takes an in person exam to fully assess your condition and offer treatment options. However, it appears from the photos that there is a depression that extends over the front of the cheek from the tear trough. The depression is due to a lack of volume, so the best way to treat that is by adding volume, whether it be filler or fat. I typically advise patients to try filler first and see if it’s getting the result they’re looking for. If it that point, they want a longer lasting solution, they may then proceed with fat grafting, which is a minor surgical operation.

True malar bags are challenging to treat. Treatment options range from filler, microneedling, micro-liposuction, laser, chemical peel, to direct excision.

Given your age, I would try filler first. And perhaps RF microneedling. It’s important to understand that there is not a one-and-done solution. It is something that will need to be addressed throughout your lifetime.