Cheek indentation/malar bags suggestions or options to fix this? (Photo)

I have cheek indentations or malar bags . They are hereditary. I have tried radiesse on my cheek to lift them up and it did worked only with one doctor I used who is up in Buffalo, I thought I would get the same results no matter where I go .. but I have not been able to get the same results. It temporary fixes the problem for 2 months at best. I tried restalyne and it gave me the tyndell effect and a little bump that I still have so no to restalyne. Any other options/suggestions please?

Doctor Answers 4

Lower Eyelid Bags, Grooves, Depressions

Semi-permanent options for correction are fat grafting, Bellafil, Radiesse, Restylane Lyft and Volluma. All fillers used to treat the naso-jugal groove are wrought with potential side effects. The FDA has warned that injection of fillers near the eye have been associated with loss of vision.
Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon.


New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Fillers Can Camouglage Malar Bags

I have been treating tear troughs and malar bags with fillers for more than three decades going back to the use of the original Zyderm I collagen filler for this purpose. The filler does not eliminate the malar bag, but simply camouflages it and reestablishing a smoother, more youthful, gradual transition between upper cheek and lower lid. 

Owing to concerns about the unwanted bluish-colored Tyndall Effect, I typically do not inject ordinary fillers in this area, such as plain Restylane, into the delicate, thin tissues under the eyes. In my Upper East Side Manhattan practice, I prefer to use Belotero Balance, which possesses little to no tendency for  engendering the Tyndall Effect. In my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available, I typically opt for Teosyal Redensity II. 

Since the infraorbital area is subject to little mechanical force (even with tight blinking), I have found that fillers injected properly in that region tend to last far, far longer than when the same filler is injected, say in the nasolabial smile lines, which are subjected to a great deal of mechanical stresses from smiling and laughing. Two months is a surprisingly short interval of time for the effects to last.

I would suggest consultation with a board certified aesthetic physician with experience and expertise in the nonsurgical rejuvenation of the periorbital area using fillers. Make sure to a ask to see his/her before and after photos.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Cheek indentation/malar bags suggestions or options to fix this?

Thank you for your question and series of photographs.  Depending on a physical exam, if these malar bags prove to be the fat around your eye pushing on your skin, you may best be served by surgery to remove them permanently.  This can be done with a small incision along the inner portion of each lower eyelid.  If you would like to continue non-surgical management, seek an experience dermal filler injector who can camouflage the malaria bags to improve your appearance.  Hope this helps. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Malar bags?

Your photos, unfortunately, do not provide enough data for meaningful analysis of your condition.. You would benefit from  a detailed clinical evaluation by an experienced board certified plastic surgeon. Transconjuctival blepharoplasty with fat transposition/resection, fat grafting?? Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.