Malar Bags (Cheek Bag) Treatment Options

Hi Michelle,
Definitely have your thyroid hormone levels tested. If normal, then I would recommend a consult with Robert Goldberg, MD at UCLA. Dr. Goldberg has a technique where he treats malar bags with radiofrequency with success.
Good luck and be well.
Dr. P

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Malar bags are on of the most difficult things to treat on the face.  Malar bags as a result from edema can be from a host of medical causes (i.e. allergies, thyroid, etc) are notoriously difficult to treat.  Treatments which fibrose the lymphatics can sometimes improve the appearance.  Isolated kenalog injections can help fibrose the lymphatics here with variable success as can some radiofrequency devices.  

Malar bags as a result of muscle excess are more easily treated and can be treated by some reshaping the orbicularis oculi muscle (lower eyelid muscle).

Malar bags or festoons can be caused by a number of issues including genetics, aging, fluid retention, lifestyle, and unknown reasons.  Without a doubt, malar festoons are a difficult problem.  Traditional lower eyelid lifts (blepharoplasty) do not fully correct festoons.  Injections with kenalog (steroid) or 5-FU may help some festoons but I have not seen injections completely treat festoons.  Fillers can sometimes blend and camouflage the area.  In my experience, the only definitive treatment is direct excision.  There is a trade-off between the festoons and the "scar".  Done well, the scar can be camouflaged, thin, and the initial pinkness will fade.  I recommend a consultation with a qualified surgeon for an exam and to discuss your options.  

There are several different reasons as to what causes Malar Bags, from inherited, stretching of the skin hence leaving excess skin, Loss of Fatty tissue. Depending on what has caused the Malar Bags will determine what the best treatment will be. There are several different options, Laser resurfacing, a form of lower blepharoplasty etc. Your best bet would be to seek a consultation with a Reputable Doctor who is knowledgeable and understands the anatomy of this area. Let him/her take a look at your area of concern so he/she can go over your best options so you can make an informed decision as to which treatment will be best.

"Dr.D"

Malar bag excision, lower eyelid lift, facial implants and fat injections for malar bags are options. Direct excision is a more direct way of approaching the malar bags. Although I show a video on the direct excision it is probably not my first choice. I would rather carry out fat injections to smooth the bags out.  The lower eyelid lift tends to remove fat from the lower eyelids and lifting of the muscle and skin can benefit the bags in the malar area.  Implants can help by filling in some of the void but are a second choice. 

Greetings Michelle,
Malar bags are a difficult problem to treat. Options that I have found useful include laser resurfacing with lower eyelid surgery and in some cases directly excising the malar bags. Direct excision seems to work the best but may not be a good option in someone your age. It does leave a scar which is usually better than the bag itself but does take several months to heal and for swelling to resolve. In some cases in younger people with minimal malar bags, a resurfacing laser, such as a CO2 laser, can be used, sometimes 2-3 treatments, to get the desired results.

Malar bags are usually due to swelling. It is like having swelling in your legs. Unfortunately there is not a lot that can be done for malar bags except to camouflage them.

 Malar bags are hereditrary and are caused by scarring due to chronic fluid retention within the upper cheek tissues.  This is a very difficult thing to treat and IMHO, your choices are either:


a thin filler like Restylane, Juvederm or Perlane to feather in the edges of the malar bags or

cheek implants, where the cheeks are also flat, to re-shape the cheek area.  This camoflauges the malar bags.  I have used cheek implants to treat malar bags on numerous occassions.  Micro-lipo and local tissue manipulations, including cautery, of the malar bags does not work, IMHO and can cause more tissue irregularity.

there are a number of causes for malar bags or whats often referred to as festoons. If there is lid ptosis or sagging this must be addressed specifically. However the malar bags are often treated in my practice with either  the erbium laser or the new CO2 fraxel laser.  If done carefully both lasers can easily shrink the malar bags symmetrically and leave the eyelids in their normal position. The proceedure is easy, done under local anesthesia and takes 15 minutes.