I have been told I have festoons, have had fillers with no luck. Would laser resurfacing help me? Cannot afford surgery (photo)

Dear Fort Worth,It appears from your photos that you have both lower eyelid bags and festoons. Fillers are not a great option for festoons because they tend to push the festoon outwards when its more desirable to have the festoons flattened. For the lower eyelid bags, surgery to remove or relocate the fullness there is suggested. For the festoons, I've had success using lasers to tighten and improve the festoons and malar mounds, Best to seek a specialist in your area for assistance. I hope this was helpful. 

Thank you for your question and photos.  Based on the photos, there appears to be several problems that most likely are a result of an aging face (loss of support, fat atrophy and decent, and skin excess). Your festoons will unlikely be improved alone by laser resurfacing.  In my experience, the best results are seen with operative management which would include a lid tightening procedure, excision of the skin excess, resuspending the cheek (midface lift), and fat transfer to smoothen the transition between the eye and the cheek.  Even with such a procedure, additional surgery may be required to directly excise the festoons.  Please be sure to see a plastic surgeon that is skilled in eyelid surgery.

Good Day,

Nicholas Jones, MD

Which filler is used and how it is placed makes a huge difference.  This is not a commodity service.  The injecting physician is critical.  Smooth fillers should not be used in this location.  That includes fillers like Belotero, Volbella, and Restylane Silk.  These products should not be used in this location.  If your recent filler service has make you worse, this product should be removed with hyaluronidase, an injectable enzyme.  I think your best option for this festoon is a phenol chemical peel.

Yes, a combination approach will give the most improvement. 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

You have a combination of festoons, beginning of ectropion and fat deposits in the upper cheeks. Fillers are contraindicated. laser resurfacing would not be helpful. Dermapen may help some . The effective treatment is surgery.

Festoons are hard to treat.  Some have found success with lasers, but it can be hard to predict.  I recommend researching board certified plastic surgeons in your area who have specific experience in successfully treating festoons.  I would take the time and meet with a few doctors before choosing a treatment plan.

Hello sugris,


Thank you for uploading
photos, this always helps.


The way I explained these
to my patients, is that there are several problems going on.


1.    
Excess skin and
tissues underneath the skin.


2.    
A structure called
a retaining ligament that holding some of the skin in place, causing a line


3.    
Quality of the skin


In my opinion, filler is
just a camouflage maneuver for your problem. It does not address the underlying
problem. Resurfacing will help primarily with problem number three, but will
not change problem number two and only helps problem number one a little bit. A
combination approach is best for you. Surgery will help problem number two and
problem number one, but you may still need some resurfacing to give you the
best result.


I would suggest obtaining
formal consultations with surgeons who have all of these tools available to
use. That way you can discuss the risks and benefits, as well as the expected
outcome of each treatment, so that you can make an informed decision.


 


I hope this helps!


 


dr. silver


 


Andrew G. Silver, MD


Las Vegas, NV

Your predicament is classic. Unfortunately, malar festoons are a difficult problem to deal with and often require BOTH surgery and noninvasive treatments (filler + skin tightening) to achieve long-lasting results that will make you happy.

Those are indeed festoons.  Higher G-prime fillers can sometimes helps, but with mixed results.  I've had some success with Radiofrequency treatments with "Fractora" and "FaceTite," which treat from outside and within the festoon respectively.  Laser resurfacing can sometimes help as well as direct excision.   I've had a few patients respond well to tetracycline injections into the festoons also.  Best regards.