Malar Bags - Festoons. What Do You Recommend? (photo)

What look like normal under-eye bags to the untrained eye (and sometimes
even to the trained eye) can actually be a condition known as Festoons.
Festoons occur when the skin of the lower eyelid experiences
significant damage, usually by the sun. This causes folds in the lower
eyelids and can lead to swollen mounds on the cheeks known as Malar
Mounds. Festoons often occur with age and are more common in people with
lighter skin types.Lower eyelid bags, in contrast, are caused when age-related fat protrudes through the skin in the lower eyelid region.If lower eyelid bags are addressed by themselves, the festoons often are more noticeable afterwards because they stand out in stark contrast. It’s important to understand the differences between these two conditions so they can be properly treated. The best rejuvenation and most natural results occur when both eyelid bags and Festoons are corrected simultaneously.The first difference is in their cause or etiology;
festoons are a result of sun-damaged skin on the lower eyelid and on the
cheek and are believed to be affected by underlying contrasting muscle
forces over the years of a person’s life.
In contrast, lower eyelid bags are due to age-related fat protruding
through the skin in the lower eyelid region. New research has shown that
fat can grow and atrophy during our lives in asymmetric ways. The
growth of fat in the orbit around the eye along with atrophy of fat in
the facial regions around the eye, as well as weakness in some of the
orbital containing structures, contribute the fullness we see in the
lower eyelid with age. For some individuals, this fat shows up at a very young age and this
is believed to a result of genetic changes in the development of the eye
area in those individuals.
The second difference is the location on the face
where they form. Lower eyelid festoons can be seen primarily on the
cheek with some presence in the lower eyelid region. Lower eyelid bags
are located directly below the lower eyelid lashes and are noticed to
become more prominent when someone with these bags looks upwards.
Conversely, festoons are minimally affected when a person looks upwards.
The third difference is the feel of these conditions
when they are touched. Festoons are squishy and can be made to move
side to side. Lower eyelid bags are firmer, deeper in location beneath
the skin and can’t be moved easily side to side when touched.I have had great success treating festoons and malar  mounds with my Laser Skin Resurfacing RESET treatment for lower eyelid festoons and malar mounds. See the video and link below for more details. 

The treatment of festoons is complex and often not 100% satisfactory to patients. The scar following surgery may be unappealing. For large festoons, direct excision along with canthoplasty and laser skin resurfacing is usually the treatment of choice. You should have an evaluation with a surgeon to discuss your goals and determine the best treatment option. All the best.