I am in my early 20s and after a period of stress I started developing these I heard: malar bags/festoons. Will they get smooth?

Question

I am in my early twenties and after a period of stress I started developing these I heard: malar bags/festoons. I didn't have these 1+ year ago, it even seems like the lines turned into some sort of scars/wrinkles now. Can this get smooth again? I am for not too long starting to eating healthy, drinking much water and trying to sleep good consistently, but I'm afraid that won't get it fixed. What do you think? Thanks

Alexander Rivkin, MD · Answer

Hi and thanks for your question. It is certainly good to eat right and gets a decent amount of sleep. Those things will be good for you in the long run. It is tough to tell from the picture exactly, but it looks like you just have hollowing in the peri-orbital area that you have probably inherited from your parents. I agree with Dr. Steinsapir, this is easily corrected with a hyaluronic acid filler. The great thing about filler in this area is that it seems to last a very long time. I have patients coming after 6 years who still do not need a touch up. Of course, hyaluronic acid fillers are always reversible, so it is easy to bring them down a bit if there is swelling or to add if we need more. This is why always set up a no cost touch up visit after the initial injection. The result in this area has to be absolutely flawless! Hope that helps. Feel free to call the office with any further questions.

Jonathan Kulbersh, MD · Answer

Dark under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella) which can also help nasolabial folds.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Jason Emer, MD · Answer

Malar bags are permanent although microneedling RF like Fractora or morpheus 8 have been shown to give improvement as has very aggressive lasers like erbium.  There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Kenneth D. Steinsapir, MD · Answer

This is not quite a festoon. It looks more like a mid-cheek groove.  There is no substitute for a personal assessment. I do not think that drinking water will fix this. The simplest option would be to use hyaluronic acid to add volume to this groove which can be used to restore the integrity of the cheek.

Camille Cash, MD · Answer

Festoons will not correct and can be challenging to treat.  A great place to begin is a consultation with an experienced injector in your area.  You can discuss your areas of concern and possible treatments to improve them.  I encourage you in addition to the good, healthy habits that you described that you also wear sunscreen every day.

Johnson C. Lee, MD · Answer

Festoons and malar bags are usually genetic and will not smooth out on their own without surgery. It is best to have in-office examination to determine what you actually have and the best treatment plan possible. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

I am in my early 20s and after a period of stress I started developing these I heard: malar bags/festoons. Will they get smooth?

Answers (6)

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