Best option for Malar Bags? (photos)

Malar bags, also called festoons, are problematic because they are not helped by traditional facelift and/or eyelid surgery.  While skin resurfacing, with a hundred different types of lasers and/or chemical peels are important parts of treatment, in my opinion, orbicularis muscle plication with lateral canthopexy is crucial to achieving excellent results and avoiding ectropion.  I think you would be best treated by an oculofacial plastic surgeon who can show you photos of other patients he/she has done.  See the directory of asoprs.org for someone near you. 

You are probably a great candidate for a blepharoplasty, eyelid lift procedure. Of all the features on our faces, our eyes are the most prominent indicators of our mood, energy level, and youth. Sagging, drooping, or tired-looking eyes can make us look older than we really feel. Eyelid surgery, or blepharoplasty, is a plastic surgical procedure designed to improve the message our eyes send to those around us.Who is a candidate?Patients who would benefit from a blepharoplasty include those who experience:
• Excessive, sagging, or wrinkled upper or lower eyelid skin.
• Excess upper eyelid skin that interferes with vision.
• Loss of your natural upper eyelid crease
• If you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.
• Orbital Rim Show: visibility of the bone under the eye sometimes contributing to a dark ring or shadowing.
Normally, everyone has a small amount of fat around the eyes. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags.” Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a profound effect on one’s appearance giving a tired or haggard appearance. An attractive face with these early signs of aging can affect a patient’s self-image, attitude and sense of well-being.
Intended ResultA blepharoplasty is a procedure designed to improve the appearance of the eyelid area. This may involve removing excess skin and if needed tightening the surrounding muscle resulting in a more youthful, refreshed appearance. This procedure can treat both the upper and lower eyelids depending on the unique needs of the patient.

A combination approach is best for malar bagsI have found that thermitight and Co2 laser works very well for this.  I suggest only going to an expert for a formal consultation.  Best, Dr. Emer.