Question about eyelid surgery and festoons

I am looking to get upper and lower lids done. I also have festoons. I have read that some patients are getting their festoons treated with laser resurfacing. Is it necessary to get all three procedures done? ( upper and lower eyelids and festoons) or can I just get upper and lower done then festoons treated with laser resurfacing?

Doctor Answers 5

Blepharoplasty & Festoon Treatment

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Thank you for your question. An upper and lower blepharoplasty procedure would be beneficial in removing loose, sagging skin, fatty deposits and rejuvenate the eye area overall. In regards to Festoon treatment, Festoons (also known as “Malar Bags”) result in a tendency for variable swelling below the lower eyelid and above the cheek. This can sometimes also be seen in other family members and have a genetic element to it. Festoons can be treated in a number of ways based on severity, depending on severity may requires blepharoplasty. Festoon and malar bags can be challenging to treat as there is a tendency for the fluid to come back even years later. It is best to select an Oculo-Plastic surgery to assess your eyelids and talk through your management options. Best of luck!

Upper and lower blepharoplasty and festoons

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If your festoons are relatively small, then it makes sense to have the upper and lower lid blepharoplasty and laser resurfacing. If the festoons are large or prominent, it may be wise to have them addressed through the lower lid blepharoplasty incision. This raises the question - are you having a transconjunctival or transcutaneous lower lid blepharoplasty? Festoons are better approached through a transcutaneous blepharoplasty incision so that the skin and orbicularis can be re-draped (agree with Dr. Kass). Best wishes with your decisions!

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

Treatment of festoons of the lower lids.

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In my practice I would recommend upper and lower blepharoplasties combined with fractionated CO2 laser treatment of the festoon area.  This can be done under one anesthetic but I would also recommend that a second laser treatment may need to be planned depending upon the severity of your problem 6 to 12 months later.
Meet with several board-certified surgeons to discuss options.
Best wishes.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Question about eyelid surgery and festoons

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Festoons treatment are not easy. I have found doing combination of Thermi Tight RF under local , than ThermiSmooth RF 250 externally fr6 sessions offers best results in my opinion... Fee $2,000.

Eyelid Surgery and Festoons

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Festoons, also called malar bags, are due to swelling and hypertrophy of the orbicularis muscle, below the lower eyelid in the area of the upper cheek.  Correcting this problem is separate and distinct from standard surgery of the lower eyelid.  While resurfacing alone plays a role and are advocated by some, in my extensive experience orbicularis muscle tightening is necessary to achieve excellent long term results.  This can be combined with resurfacing (which in my hands is better accomplished with deep chemical peeling than with a laser) and eyelid surgery for best results.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 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.