I don't have eye bags, but bags across the top of my cheeks. From numerous google searches, I think these could be known as Malar Festoons? I am confused about whether they are caused by fluid retention or are simply part of the aging process (although I am only 30 and don't have any other signes of aging). They began appearing a couple of years ago, but would only show when I was stressed or had not slept well, now they are a permanent fixture.
December 20, 2018
Answer: Fat vs. Filler You are correct that your description does sound like cheek festoons. We would need a physical exam to determine the tissue plane that is affected. The orbicularis oculi muscle is the sphincter muscle around the eye. This muscle can become thinned and redundant (you are young for this, but with enough sun damage it can happen), which can lead to this issue. Fat can also prolapse and fall. This can be orbital fat or the mid cheek fat pad. It is important to delineate the cause so that it can be corrected appropriately. In my opinion you should see a facial plastic surgeon, get a good facial analysis, and consider fat grafting vs. filler to transition this area. Hope this helps. Best of luck, DrC
Helpful 1 person found this helpful
December 20, 2018
Answer: Fat vs. Filler You are correct that your description does sound like cheek festoons. We would need a physical exam to determine the tissue plane that is affected. The orbicularis oculi muscle is the sphincter muscle around the eye. This muscle can become thinned and redundant (you are young for this, but with enough sun damage it can happen), which can lead to this issue. Fat can also prolapse and fall. This can be orbital fat or the mid cheek fat pad. It is important to delineate the cause so that it can be corrected appropriately. In my opinion you should see a facial plastic surgeon, get a good facial analysis, and consider fat grafting vs. filler to transition this area. Hope this helps. Best of luck, DrC
Helpful 1 person found this helpful
September 10, 2017
Answer: A Difficult Problem You are probably right. By the information you provided, these are most likely malar festoons. These can be very difficult to fully eradicate. I recommend patients try a low salt diet and even antihistamines (Claritin, Zyrtec, etc.) as occasionally this will improve their appearance. I have injected a steroid solution under the skin in this area and have had some patients respond to this treatment. Otherwise, surgery would be indicated. At your age, direct excision would not be recommended as the resulting scar would be more eye catching than the festoon. My personal recommended treatment technique would be a transblepharoplasty midface lift. Through an incision just under the eyelashes, the underlying muscle is released from the cheek bone, elevated and secured in a higher position, excess skin and muscle is then excised. This usually does an excellent job in creating a smoother cheek, however, the resulting scar to the side of the eyelid can take a few months to become inconspicuous. By the way, an endoscopic midface lift would NOT improve this condition. I recommend you see a surgeon with extensive experience with this technique as resulting potential complications, such as pulling of the lower eyelid, can be very difficult to correct, and prevention of this is key. I hope this helps.
Helpful 2 people found this helpful
September 10, 2017
Answer: A Difficult Problem You are probably right. By the information you provided, these are most likely malar festoons. These can be very difficult to fully eradicate. I recommend patients try a low salt diet and even antihistamines (Claritin, Zyrtec, etc.) as occasionally this will improve their appearance. I have injected a steroid solution under the skin in this area and have had some patients respond to this treatment. Otherwise, surgery would be indicated. At your age, direct excision would not be recommended as the resulting scar would be more eye catching than the festoon. My personal recommended treatment technique would be a transblepharoplasty midface lift. Through an incision just under the eyelashes, the underlying muscle is released from the cheek bone, elevated and secured in a higher position, excess skin and muscle is then excised. This usually does an excellent job in creating a smoother cheek, however, the resulting scar to the side of the eyelid can take a few months to become inconspicuous. By the way, an endoscopic midface lift would NOT improve this condition. I recommend you see a surgeon with extensive experience with this technique as resulting potential complications, such as pulling of the lower eyelid, can be very difficult to correct, and prevention of this is key. I hope this helps.
Helpful 2 people found this helpful