Can Lasers get rid of my festoons? (photo)

Festoons are a medical condition in which the skin of the lower eyelid
becomes significantly damaged, usually by the sun. This damaged skin can
result in folds in the lower eyelids and can lead to swollen mounds on
the cheeks. They often occur with age and are more common in people with
lighter skin types. There do exist certain inherited forms of lower lid festoons but most are related to sun exposure over time. Festoons and malar mounds have been a frustration for surgeons for many
years. Thanks to the initial work of Dr. Sterling Baker, I now have a sophisticated, technically-challenging but effective treatment for festoons and malar mounds. I use a Dual Pulsed Erbium laser to create a controlled injury in the skin in the area of the festoon and then coax the skin back to a tighter, healthier and more attractive state. This can make a big improvement in lower eyelid festoons and malar mounds in my hands. Take a look at the link below for more information.

Hi
Laser will not get rid of festoon to any degree that you or I will be satisfied with.  You facial anatomy doesn’t appear consistent with such degree of festooning... wondering if you have ever experienced sudden weight loss or metabolic issues... 
In any case your surgery will involve maximum lift of the lower eyelid skin and underlying muscle with lateral extension of incision scar laid well beyond the canthal angle...to prevent drooping of your eyelid and possible ectropion, you will need Midface lift of the cheek eminence through both eyelid approach as well as temporal approach... conventional eyelid surgery alone will not improve the festooning much... I would recommend seeking consultation with a few Surgeon familiar with the complex anatomy of the peri-orbit as well as temporal, forehead, and mid-face region.. with due diligence you willing find a competent Surgron near your area who can help you improve upon the degree of festooning, but you will be disappointed if you are wanting complete resolution.... Good Luck!

Unfortunately, there are no perfect solutions for festoons. As others have mentioned, often surgery is needed, which would trade the festoons for a thin scar. Laser resurfacing may "get rid of" mild festoons, and will likely improve moderate festoons, but would not eliminate them. Fat grafting would plump up the cheeks and may give some additional benefit, but I would not guarantee that.

In general, with the degree of festoons displayed in the photograph a laser treatment to the area probably won't "get rid" of the festoons.  A CO2 laser resurfacing procedure will improve them, however.   In all likelihood you will need a combination of surgery and volume augmentation (fat transfer) to the surrounding areas.  However, an in-office consultation is needed to better assess the area and review your health history, if any.I hope this helps.

Based on the magnitude of the problem it is highly unlikely that CO2 laser by itself would correct the Festoons. The orbicularis muscle requires repositioning for successful treatment.

Festoons are a particularly difficult problem to treat. They will not be eliminated by laser treatment, so surgery is usually the best approach. The problem is, although they are loose folds of skin and muscle related to the lower eyelid, they are not correctable via a lower blepharoplasty approach. Nor are they corrected by any kind of facelift. Direct excision will get rid of them, but as already mentioned, you will be trading them for a thin scar.

Lasers are often inadequate for festoons. Festoons are often dues to laxity of the skin and msucle. A squinch test may be helpful to see how best to treat it. Surgery is usually the best approach.

Based on your one photo, it is highly unlikely that you would achieve a satisfactory cosmetic improvement of your festoons with a laser treatment or any non-surgical procedure.It is important to realize that
following the advice from a surgeon on this or any other website who proposes
to tell you exactly what to do based on a limited photo without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest you find a plastic surgeon
certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.

Facial rejuvenation needs to be
individualized. What would be an ideal approach for one patient is not
necessarily the same for someone else. Based on the examination and discussion
at the consultation, you should have a better understanding of the various
options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Thanks for your question and your photo.Your lower eyelid bags or festoons are certainly treatable with CO2 laser. You would get some contraction of the skin and the fine crepiness will even out. I fear however that you have festoons secondary to mid facial descent.Treating the festoon issue alone won't treat the cause.In your case I would look to be performing a mid and lower face lift to elevate the facial soft tissues back to the middle third. This would support your under eye soft tissue structure. Only then would I address the festoons. I would do this with a transconjunctival lower blepharoplasty, skin pinch excision and then CO2 fractionated laser.Best of luck!

Hello,Festoons can be corrected and softened thru a surgical approach.  Expect some swelling and bruising,however it does the trick.  It would soften your look and rarely needs to be done a second time.