Swelling or Malar Bags/Festoons? (Photo)

I had upper and lower Blepharoplasty (lower via transcutaneous incision) one month ago today. At my follow up appt I asked about these bags below my eyes. Doctor said it could still be residual swelling from surgery, or it might be Malar Bags or Festions. Is that what these darker colored puffy places are?? If so, can they be surgically removed or tightened? They are not as noticeable without makeup. Concealer and makeup seem to make them more obvious.

Doctor Answers 9

Festoons vs. Swelling

Thank you for your question.  Without more information about the details of the procedure performed and preoperative photographs it is difficult to answer your question.  I recommend discussing further with your surgeon.  If you choose to see another physician, they will most likely want to see your preoperative photographs and operative notes.  Best of luck.

Nashville Oculoplastic Surgeon
4.8 out of 5 stars 40 reviews

Swelling after blepharoplasty

By the looks of your photo, I'm guessing that you have a little bit of residual swelling that will improve over the next month or two. I would call this "malar edema" but that only means cheek swelling. If you had the swelling before the surgery, then it might not get better. If you did not have malar edema before the surgery, it should resolve. I'd discuss your concerns with your surgeon.
Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Healing Post Blepharoplasty

Thank you for your question. You are one month into a one year healing course. Your swelling can fluctuate over time. Keep up communication with your surgeon. At one year a final evaluation can be done and any revisions/additions discussed then.Best wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 26 reviews

This may slowly resolve.

This type of swelling can take several months to resolve.  When it does not resolve options include additional surgery or a chemical peel to tighten the relatively loose skin present in this area.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews


You are still very out from surgery. It takes 4-6 months for most of the swelling to subside.It not uncommon to get swelling in the malar fat pad from eyelid surgery. Sleep with your head elevated.

Deborah Sillins, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 10 reviews

Malar fat pads

Thank you for your question.The fullness of the tissues that is visible on your upper cheek/eyelid junction are known as malar fat pads.  Although I do not have a preoperative photograph of you to compare, these are most likely due to swelling from your recent surgery.Head elevation, cool compresses, massage, ultrasound therapy and avoidance of overhydration, which are usually recommended by your Plastic Surgeon, can help these resolve more rapidly. Good luck with the rest of your recovery!

Daniel M. Calloway, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 40 reviews

Lower lid swelling

This is swelling in the malar fat pad.  When it is severe it is called a festoon.  It is common for people to have some swelling in this fat pad after a lower lid bleph.  IT can take a few months for this to resolve completely. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Malar bags versus festoons

These areas are Malar bags, a specialized tissue structure which is fibrofatty in nature.    They can be improved with Face lift but not removed.  Occasionally I have treated them with Steroid injections which are not always successful and can have some mild risks.  They can be camouflaged with volume fillers of the malar area.

Richard O. Gregory, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 11 reviews

Post-operative swelling vs. festoons

Post-operative swelling after blepharoplasty surgery is highly variable and depends on a number of factors such as surgical technique, age, patient healing, whether steroids are given, how much bruising there is, and other factors.
If you are only 1 month out from surgery, there is likely still edema (swelling) that still has to resolve and things will continue to improve over the next couple months.
Malar bags or festoons would have been present before surgery and would have been visible before surgery (or exacerbated by post-operative swelling).  These can be treated surgically or with laser skin resurfacing.
Best of luck in your post-op recovery.

Bradford W. Lee, MD, MSc
Palm Beach Gardens Oculoplastic Surgeon

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.