Do I have festoons? Is there anything that can be done for this condition? I am 33 years old. (photos)

Question

Do I have festoons? Everything that I've read says that there is nothing that can be done for this condition. Do you have any recommendations?

Kenneth D. Steinsapir, MD · Answer

You may also have a bit of a festoon but they may not show in these pictures.  Be careful about over aggressive skin treatments to this area which can cause skin atrophy.  What you really need here is some volume in the form of hyaluronic acid fillers.  I prefer Restylane for this area.  You also demonstrate mild upper eyelid ptosis with levator dehiscence.  There is a compensatory brow elevation. The upper eyelid would benefit from surgery.  The under eye filler is a treatment that can last about a year before requiring a top off.  Look very carefully for a highly experienced injector.

Adam Scheiner, MD · Answer

Dear Patient from Texas,From your photos, It does seem that you have swelling on your cheeks consistent with Eyelid festoons/ Malar mounds. They often have a relation to past sun exposure but can run in families in some individuals.I've had success using lasers to tighten the skin in this region.I'll include some links below. I hope this was helpful.

Catherine Winslow, MD · Answer

Hello! I would recommend trying a small amount of filler to the cheekbone/tear trough region to improve the contour. Choose an experienced injector as that area of the face can be tricky. Good luck!

Jason Emer, MD · Answer

These look very mild, but can be improved with a combination. Fractional nonablative (clear and brilliant, Fraxel), radiofrequency (sublative, viva), co2 resurfacing and microneedling/prp will give great results.  Fillers in this area help as well.  Please see someone with experience in treating this area. Best, Dr. Emer.

Camille Cash, MD · Answer

Fillers may help to give you a smoother contour to the area that concerns you.  In addition you may consider lasers to help tighten and improve the skin.  Just like we use many tools to get our hair the way we want it (shampoo, conditioner, styling products, irons, etc) so it may take a combination of tools to achieve the look you desire.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

you do have mild lower eye bags which given your age probably means that they are a a familial trait.  The first step for you would be some kind of skin tightening procedure like fraxel laser or a chemical peel. Cheek volume will correct the problem if you are feeling a little braver and want more of a mid face rejuvenation makeover. Hope that helpsAdam Goodwin

Do I have festoons? Is there anything that can be done for this condition? I am 33 years old. (photos)

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