Eye troughs/malar bags/festoons, whats the best solution for removing them? I'm 30 years old with hypothyroidism. (photos)

Question

I've been told recently that I always look tired, which I definitely do. I believe I have malar bags/loss of volume but was hoping for some more input. I'm 30 years old, have hypothyroidism, I do exercise frequently and take creatine. I've lost quite a bit of weight within the last few months. My sleeping pattern isn't the greatest either. Any thoughts on the condition and the best solution? From what I've researched so far it seems like fillers would be the correct route.

Jonathan Kulbersh, MD · Answer

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Adam Scheiner, MD · Answer

Dear Coutes,It appears from your photos that you do have festoons/ malar mounds. These are swollen mounds on the cheek and eyelid region. They often occur in those with lighter skin types and generally have a basis in past sun exposure. They are difficult to treat but I've had success using lasers to tighten the skin in this region and improve the appearance of these festoons.I'll include a link below. I hope you found this helpful.

Alexander Rivkin, MD · Answer

Hello and thank you for your question. The mild volume loss in your tear trough can be treated very well without surgery. Using a non invasive treatment of hyaluronic acid filler injections, like Juvederm or Restylane, we can give you a well rested and smooth appearance.  The effect of the injections lasts several years (I have seen patients 6 years after the procedure who still look great), looks compeletely natural and the fillers are reversible at any time. Reversibility in this area is important because fillers here can swell and it is nice to have the ability to fine tune the results. Be sure to consult with an injector who is very expeirenced in treating the undereye area. It can be a tricky procedure. Best of luck!

Arthur Shektman, MD · Answer

I think that fillers are your best option. Different fillers exist and each has advantages and disadvantages. Discuss all of this with your plastic surgeon, but there is clearly a benefit in this for you.

Mitesh Kapadia, MD, PhD · Answer

I think fillers would help. You have very little volume in your upper cheeks, so adding filler to this area and possibly under your eyes should help give you a less tired look.

Eye troughs/malar bags/festoons, whats the best solution for removing them? I'm 30 years old with hypothyroidism. (photos)

Answers (7)

Answer: Cheek volume

Answer: Cheek volume

Answer: Festoons

Answer: Festoons

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Eye troughs/malar bags/festoons, whats the best solution for removing them? I'm 30 years old with hypothyroidism. (photos)

Answers (7)

Answer: Cheek volume

Answer: Cheek volume

Answer: Festoons

Answer: Festoons

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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.