Malar festoons/bags, is there a solution? please help! (photos)

Question

Hello, I've done a lot of research on this but I'm not finding a lot about solution. I think mine is mostly genetic, maybe fluid retention, but it's really starting to make me feel terrible. I have tried fillers, it somewhat helped but also made worse. I have had to get dissolved and trily again. I was also told I may need threads. I was wondering if ultherapy could possibly help? 38,NS, healthy, and train Brazilian Jiujitsu, so not sure what the best options are since I take impact.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Thomas A. Mustoe, MD, FACS · Answer

Unfortunately there is no reliable solution.  Filler can cause swelling and low
Grade inflammation. For that reason fat grafting is better
Solution but it is also not fully predictable and reliable.  Threads even if they give temporary 
Improvement are very temporary and repeating them every year not a good idea: eventually the scarring process from the threads will get in the way.  A midface lift can also work, but not predictably.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

You need to have a consult with a plastic surgeon.  They can reposition your fat pad or removed it.
Fillers can make it worse as they can effect the lymphatic drainage system.
See an expert!

Malar festoons/bags, is there a solution? please help! (photos)

Answers (4)

Answer: Plastic surgeon

Answer: Plastic surgeon

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Malar festoons/bags, is there a solution? please help! (photos)

Answers (4)

Answer: Plastic surgeon

Answer: Plastic surgeon

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Recommended reading

Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.