Malar bags still present after lower blepharoplasty. Treatment? (Photos)

Question

I just got lower blepharoplasty surgery about 2 weeks ago. Before the surgery I definitely had prominent mylar bags. My surgeon said he would try to pull them up but recommended filler surgery to make them less prominent. I still have the bruise but it is right where the mylar bag was and it looks worse. What treatment would be the best as I have read that fillers will make it even more puffy?

Jessica Lattman, MD · Answer

Since you are only 2 weeks out from your surgery, the malar bags may still be swelling.  I would wait another 6-8 weeks for the swelling to completely resolve.  If the bags are still there at that point you may need further treatment.  I would also follow up with your surgeon.

Kenneth D. Steinsapir, MD · Answer

However, it would be best to heal more before having this service in my opinion.  I would recommend waiting until all the bruising has resolved at a minimum.

John J. Martin, Jr., MD · Answer

You look much better than pre-op and it is completely normal to have edema in this area for several weeks after a surgery.  Need to give it time to heal.

Edward Szachowicz, MD, PhD · Answer

Most lower eyelid surgery is done when membrane holding the fatty tissue around the eyeball gets weak and allows the fat to bulge. The eyeball fat is soft and is above the lower bony margin of the eye socket. However, malar bulges on the cheek itself (there is bone directly under the malar bag) are not often corrected with lower eyelid surgery. Eyelid surgery itself causes some swelling and this can make the malar bag area look more swollen until the healing is complete.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

At two weeks postop, you are not seeing your final result. It is not unusual to have localized swelling. Continue to follow your surgeon's postoperative instructions and if this issue persists, discuss with your surgeon.

Steven Wallach, MD · Answer

Malar bags often do not improve with surgery but can get more swollen during the initial post-op period.

Katrinka L. Heher, MD · Answer

It's too early for filler but you do appear to be a good candidate for voluma injections into your cheeks.  The malar bags are created by pooling fluid and this will be be worse for up to 3 months after your surgery.  Once they are back to baseline, voluma can be injected around them to blend them with your new cheek volume. I think you'll love your result. Best of luck.

Jasmine Mohadjer, MD · Answer

Dear lfritts,At just two weeks after surgery you are certainly still seeing a good deal of surgery. I would wait at least 2-3 months to allow things to completely heal before I'd consider anything else. I think you will see a nice difference at that time. Good luck!

Donald Nunn, MD (retired) · Answer

At two weeks you still have swelling that could be hiding the final result.  Some swelling may take several months to completely resolve.  This is especially true for swelling of the malar bags.  I would not consider any additional treatment until all swelling has resolved.   Follow up with your surgeon for guidance.  Good luck.  Donald R. Nunn MD   Atlanta Plastic Surgeon

Malar bags still present after lower blepharoplasty. Treatment? (Photos)

Answers (9)

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