Mid cheek lines/volume loss - how can I improve malar bag area? (Photos)

Question

Last year I had tear trough filler to address the mid cheek lines and volume loss in my face. I didn’t like how it made me look more puffy and accentuated the med cheek lines more. I had it dissolved a few sessions. After that I had mid cheek filler only. Since then I’m left with these puffy bags from what I’ve researched I think are malar bags? How can I address them?

Anna Chacon, MD, FAAD · Answer

I completely understand your frustration, the mid-cheek area is such a delicate part of the face, and when filler doesn’t give the result you were hoping for, it can really feel discouraging. You’re absolutely right that what you’re seeing looks like malar bags, which are tricky because filler can sometimes make them more noticeable instead of better.

Here’s what can help:
Avoid more filler directly in that area – since it can make puffiness worse.
Skin tightening treatments like radiofrequency microneedling, ultrasound, or fractional lasers can firm up the tissue and soften the look of the bags.
In some cases, surgery (like a lower eyelid or midface lift) can give the most definitive improvement if the bags are very pronounced.
Everyday things like allergies, sinus issues, or fluid retention can also make them more noticeable, so managing those sometimes helps too.

I want to reassure you that you’re not alone in this, many people deal with the same issue after filler in this area. While malar bags can be stubborn, the right approach can make a real difference, and often it’s about supporting the skin and surrounding areas rather than putting anything directly into the bag itself.

You’re on the right track by asking the right questions and paying attention to how your face has responded so far. With the right plan, you can definitely see improvement and feel more confident again.

Lexie Wang, MD · Answer

these are commonly associated with excess fluid in the face, so decreasing that is going to be key. you can improve fluid egress (lymphatic massage), decrease fluid production (anti-allergy treatments, low salt diet), and if it's because there's a dead space forming there, you could also consider trying some radiofrequency there to try to shrink that down.

Darryl J. Blinski, MD · Answer

Based on your post photos, recommend virtual consultation. My recommendation would be in Endo laser treatment under local anesthesia. Fee $5000. Again, best of virtual concert.

Mid cheek lines/volume loss - how can I improve malar bag area? (Photos)

Answers (3)

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