Malar Festoons: Two Questions?

As Dr. Amadi alluded to this is a difficult problem to treat. It's critical that people with festoons don't undergo a lower blepharoplasty alone to improve this area as it will lead to disappointment. Resurfacing, skin excision and fillers can be helpful in some cases. Often, multiple approaches or multiple treatments are required to provide the desired level of improvement. Lastly, asymmetry is the rule rather than the exception and it totally normal. I hope this information is helpful.Stephen Weber MD, FACS

Malar festoons are often asymmetric.  Their treatment is difficult.  In fact, this is an area of facial surgery in need of much better solutions.

 

Unfortunately,  the fluid can not be simply aspirated from festoons.

 

 

      I have used fillers and laser resurfacing to help with this condition.  Usually multiple modalities are needed.  Due to the fact that the swelling is not going away, fat grafting for camouflage provides a more durable solution that temporary filler.  Also, people with these festoons do benefit from diuretics, but these should never be prescribed for cosmetic purposes.  I notice this most commonly with patients starting thiazide diuretics to control high blood pressure.