Treatment for Festoons Under Eyes?

Question

I have festooning under my eyes -- big, loose bags across the cheek bones. Some days, the bags are almost unnoticable, some days I look deformed. What is the cause and what is the cure? What is the risk and what is the cost?

James R. Gordon, MD, FACS, FAAO · Answer

Festoons can be caused by several conditions, including fluid or a weak muscle in the eyelid/upper cheek. It can be a difficult problem to treat, but satisfactory results can be achieved. One good option is removing loose skin & muscle and elevating the tissue upward. This is followed by laser skin resurfacing to further tighten the skin and smoothen the surface. If this is not sufficient, then a direct excision of the festoon may by necessary. I hope you find this helpful.

Brian Maloney, MD, FACS · Answer

The eye is surrounded by a circular muscle, over time the lower portion can relax and pile up, resulting in a bulge on the upper cheek bone called a festoon.

	An incision made under the eyelashes can be used to raise the lower eyelid skin from the underlying muscle. The muscle can be trimmed and the excess skin removed. Sometimes if the puffiness is due to fat instead of muscle( if the bulge moves when slight pressure is applied to the eye when closed) the fat can be removed from an incision on the inside of the eyelid and the skin can be lasered with the carbon dioxide laser.

Armando Soto, MD, FACS · Answer

Hi there-
An examination would be necessary to be sure of exactly what is causing your problem, but if you have true festoons, these are caused by redundancy of the orbicularis occuli muscle (the muscle responsible for closing your eyes and producing a squint).
The only way to improve true festoons is to surgically trim the redundant muscle and skin. The surgery is relatively simple and quick, and usually done as an outpatient.
I recommend you find a surgeon certified by The American Board of Plastic Surgery and visit for a consult.

Rafael C. Cabrera, MD · Answer

I'm guessing you are not a 70+ year old man? pity. the treatment in that age group is simple excision with excellent results. they are the result of fluid accumulation in the recess of Eisler. the triangular floor of the orbicularis oculi muscle. lower lid bleph is the traditional treatment with muscle suspension usually added. but be warned results not always ideal as the physiology is not cured and the recess is lifted but generally not obliterated. good luck

Treatment for Festoons Under Eyes?

Answers (4)