What can be done to reverse my malar bags: filler, RF, CO2, microneedling or other? (photos)

Question

Hello! My malar bags have gotten so much worse the last couple years (I'm 32). Is there anything that can be done to reverse this? I've tried juvederm and it became ridge-y and would love something that could prevent it from getting worse... CO2 laser or surgery or RF microneedling or something like Sculptra? Any recommendations for dr's in OC/SD/LA that specialize in malar bags would be greatly appreciated! Thank you!

Nima Shemirani, MD · Answer

Hi @Shannon C. Malar bags can be difficult to treat. I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

Best of luck,

Dr. Nima

Best of luck,

Dr. Nima

Prem Tripathi, MD · Answer

Malar bags are one of the more frustrating aspects of our field since so many factors contribute to their development but there are things you can try. Assuming no other systemic issues:
-The least invasive is to try a combination of 5-FU and / or kenalog injection to shrink them. -Minimally invasive treatment such as FaceTite can be done to try and shrink them-They can be surgically removed but this leaves a scar
I would not recommend fillers to camouflage the area. CO2 or RF microneedling may help but the degree to which they will improve is unknown. 
I recommend Dr. Kami Parsa in Beverly Hills who has good success with FaceTite

Jason Emer, MD · Answer

there is no cure for this. regular RF facials every 2-4 weeks, plasma pen, morpheus and co2/erbium/halo lasers in the office to control it. id suggest at home cosmelan or enlighten peels and MTS roller emeragecosmetics now.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello Shannon.  Thanks for your questions and sorry to hear about your situation.  In our practice, we typically use fillers.  If the Juvederm did not work out to help in this area, perhaps the placement was not exactly where it needed to be.  Also perhaps a less hydrophilic product like Restylane or Lyft may work better.  In either case, we believe filler is the best way to go as the issue is volume loss directly below the cheekbone and this is caused when the large fat pad blow the cheekbone decreases in size and also starts to move downward with age.  Best of luck.

Camille Cash, MD · Answer

Malar bags are difficult to treat.  Some patients find improvement with lasers or Morpheus8 treatments.  Most find that fillers alone can make the condition appear worse.  See a board certified plastic surgeon near you to learn more.

Brooke R. Seckel, MD, FACS (retired) · Answer

Surgical correction of malar bags requires a visible incision starting at the side of the eyelid and extending out on the cheek.
Most people do not want the scar. Some benefit can be accomplished with filler injection with Restylane Lyft or Voluma under the malar bag to camouflage the Festoon

What can be done to reverse my malar bags: filler, RF, CO2, microneedling or other? (photos)

Answers (6)