I got festoons or malar bags on my cheekbones. (Photo)

Question

I got small festoons on my cheek bone. And it been almost 2 years and it never go away. So what should i do to get rid of this?

Brett S. Kotlus, MD, MS, FACS · Answer

Thank you for your question.Based on your image, you appear to have malar mounds. The lower boundary of the mound represents the tight connective tissue attachments between the lower edge of your cheek bone and your skin.  This trait is seen in both young and old but can become more pronounced with age because the blanket of fat under your skin lessens with time, exposing the underlying structure. You may reduce the appearance of the mound by adding a stiff gel filler to crease under the mound.  Laser can help in firming the skin of the mound but I would be cautious with your skin type.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about eyebag treatment. Fillers would be a wonderful treatment option for you.  In our office we use hyaluronic acid (HA) fillers.  Hyaluronic acid occurs naturally in our bodies: in our skin and joints.   JUVÉDERM VOLUMA, a product by Allergan, is a sterile, biodegradable, viscous injectable gel filler.  This facial filler restores age-related volume loss for up to 2 years in adults over the age of 21.  Voluma is injected into the deeper tissues of the mid-face and cheeks to restore volume and fullness, giving a more youthful and smoother appearance. The gel is the first and only HA filler with lidocaine FDA-approved for this purpose. 
 
 To be sure, see two or more experienced, 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 treatment.
 
 I hope this helps.

Jason Emer, MD · Answer

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

Kenneth D. Steinsapir, MD · Answer

What you have is a visible mid face groove.  It is part of the change that eventually may result in a festoon, a type of eye bag.  There are may approaches to these but the punishment should fit the crime.  The most reliable approach is to use hyaluronic acid filler to carefully fill the mid cheek groove.  Restylane is my preferred product for this.  Who does your service makes all the difference.  You need a very experienced injector for this.  Don't go to an unsupervised medical spa for this.

John J. Martin, Jr., MD · Answer

You are seeing the outline of the malar fat pad.  This can occur in all age groups, but is more common as we age.  It is tough to treat!  You don't want to remove this fat pad.  You can try to put some filler around it.  laser can sometimes help but results are inconsistent.  Even with surgery there can be some persistent swelling in the fat pad.

Adam Scheiner, MD · Answer

Dear Fresno,Festoons and malar mounds indicate swollen mounds that can appear on the cheek and lower eyelid region. They usually occur with age and are more common in individuals with lighter skin types. They then to have their origins in previous sun exposure in our lives. They can make a person appear tired, sick and older even when they feel fine inside. I've had success using laser to help improve malar mounds and eyelid festoons.I'll include a link below.I hope this was helpful.

Joel E. Kopelman, MD, FACS · Answer

Thank you for your question. From your picture, I understand that you have festoons or malar mounds. A condition such as this will become more prominent as you age, so it is a good idea to treat it soon. 
I would recommend a combination approach of laser treatment and hyaluronic acid fillers. Fillers such as Juvederm ® can produce immediate and dramatic improvement. JUVÉDERM VOLLURE&trade; XC is the latest FDA approved hyaluronic acid filler mixed with lidocaine (for improved comfort) and new longer lasting treatment option (lasting from 15 to 18 months) for facial contouring and the treatment of deep skin depressions.
 Laser treatments such as Fraxel are also beneficial. The Fraxel ® laser’s energy penetrates into the dermis and stimulates fibroblasts to produce a layer of new collagen which thickens the skin.

Camille Cash, MD · Answer

You may find that a combination treatment will give you the best results.  Malar mounds are difficult to treat, but some find improvement with the use of lasers.  Artful use of fillers may help disguise some irregularities.  I recommend visiting with an experienced injector in your area for a consultation.

Edward H. Bedrossian, Jr., MD · Answer

Festoons / Malar bags can be difficult to treat. Seek  consultation with an experienced Oculoplastic or Facial plastic surgeon, who will evaluate your skin type and anatomic reason for your complaint . If  the 'mounds' are mostly skin, then excision or laser treatment may be advised. If they are mostly fat, then filler or surgery may be advised. You may benefit from a combination of treatments.

Ritu Malhotra, MD (license suspended) · Answer

Your fat pads are located below the skin's surface and provide volume, facial contours, and fullness.
As we age, fat pads get thinner and descend separating from each other and causing that malar groove. My favorite fix for that is Voluma which is a Hyaluronic acid filler resulting in improved contour of the upper cheek and the lower eye- upper cheek interface.

I got festoons or malar bags on my cheekbones. (Photo)

Answers (10)

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