I have under eye festoons or Malar bags that I want removed. What is the best treatment? (photo)

Question

I had one doctor offer to remove the fat. Would that be the best treatment?

Adam Scheiner, MD · Answer

Malar Mounds and Festoons are terms used to describe the skin folds and 
swelling of the lower eyelid and cheek which form as a result of years 
of sun damage and underlying forces under the skin caused by contrasting
 muscle action. Festoons, along with lower eyelid bags, can make us 
appear tired or sick even when we feel great inside. Patients with this 
condition often report that others think they are perpetually tired 
based on the appearance of these Festoons and Malar Mounds. It can be 
frustrating for those who feel otherwise fine to be perceived as tired 
when they are not. 
While some people have a family genetic predisposition to Malar 
Mounds and eyelid Festoons, most people develop them as a result of sun 
damage to the fragile skin in the lower eyelid and cheek region. Small 
doses of unprotected sun exposure over our lifetime can be as damaging 
over time to the skin as the few sunburns we had in our youth.
The best way to improve lower eyelid Festoons and Malar Mounds is to 
address the cause, which is the tissue sun-damaged over time.  
Procedures like my RESET procedure for Festoons and Malar Mounds use 
lasers to remove past sun damage and then allow new skin to grow back in
 its place. This new skin has brand new collagen and elastic fibers 
which tighten the skin and this is one of the best ways to improve lower
 eyelid Festoons and Malar Mounds. 
I hope you found this interesting.

Franklin D. Richards, MD · Answer

It appears from your photo that you have a true festoon which is different than eyelid bag fat. There are a number of procedures that can be performed to correct the fulness you have in this area. It is extremely difficult to be able to determine which treatment option would be best for you without an examination. Injecting fillers in an attempt to mask this fullness will not work well unless the festoon is exceptionally small.

Brian S. Biesman, MD · Answer

Malar festoons are tough problem to treat.  They can sometimes be camouflaged with injectable fillers and lower eyelid blepharoplasty and or midface lifting can also produce some improvement.  Aggressive laser resurfacing can also be used.  This is a condition for which I would strongly recommend seeking the opinion of someone who has a great deal of experience

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about eye bags treatment.For correction of your tear trough, injectable filler may camouflage this area.  Lower lid blepharoplasty might provide a more permanent fix.To be sure, see two or more licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have these treatments.I hope this helps.

Richard H. Tholen, MD, FACS · Answer

Your photo shows a prominent tear trough or nasojugal groove. HA filler would be the best option and should be your first consideration, as these injections are straightforward (in expert injector hands) and helpful for 6-12 months. Repeat injection when the grooves become more visible again can always be done. Down-time is none to minimal (slight occasional bruising) and this is truly a lunchtime procedure. If you like the look of the HA filler injections but grow weary of the repeat visits, injections, and cost, you may wish to consider fat grafting.Please take the time to see one or more ABPS-certified plastic surgeons for direct examination and advice. Do not allow fat removal; this is not an excess but a deficiency situation. Best wishes! Dr. Tholen

I have under eye festoons or Malar bags that I want removed. What is the best treatment? (photo)

Answers (10)

Answer: Eye Bags Treatment

Answer: Eye Bags Treatment

Answer: This is not a festoon or malar bag.

Answer: This is not a festoon or malar bag.

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

I have under eye festoons or Malar bags that I want removed. What is the best treatment? (photo)

Answers (10)

Answer: Eye Bags Treatment

Answer: Eye Bags Treatment

Answer: This is not a festoon or malar bag.

Answer: This is not a festoon or malar bag.

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.