Are these malar bags/festoons? (photo)

Hi. I'm 21 yr old male with what I believe to be malar bag/festoons. I started noticing them about 1 year ago and it has steadily worsened. I'm a smoker of 2 years and work in the sun almost everyday (without sunscreen). The bags become more prominent when I squint as I can see a crest like curve from the inner part of the tear trough and continues around to the other side of the eye (left eye only) any help or advice on the matter would be greatly appreciated.

Doctor Answers 3

You have herniated eyelid fat, not malar bags or festoons

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Thank you for your question and photograph.  The puffiness that you see is eyelid fat pushing against the skin which we refer to as herniated intraorbital fat.  This can be removed with a procedure called blepharoplasty.

Fortunately you do not have malar bags or festoons which appear as fluidlike swelling further down on the cheek, to the side of the face.

Malar bags vs herniated fat.

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The bags under the eyes on your photos are caused by herniated fat.  These kind of bags often appear at an early age and in many cases run in the family.  They are much easier to get rid of than malar bags or festoons.  The later are caused by fluid accumulating under the eyes and are very resilient to treatment.  The procedure to get rid of herniated fat is called blepharoplasty.  In many cases it can be performed trough small incisions on the inside of the eyelid, leaving no visible scars.  Good luck! 

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 51 reviews

Malar bags

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Thank you for the photos and they do not appear to be malar bags and are more likely a small amount of herniated fat. I would see a local PS or Oculoplastic surgeon and be evaluated Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 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.