how can you treat/camouflage festoon? Will microneedling, RF or ultherapy work? (photos)

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Dear NYC,It appears that you have a festoon or malar mound in your eye region. Festoons are a medical condition in which the skin of the lower eyelid becomes significantly damaged, usually by the sun. This damaged skin can result in folds in the lower eyelids and can lead to swollen mounds on the cheeks. They often occur with age and are more common in people with lighter skin types.They are difficult to treat. But I've had success using lasers to improve this condition. I'll leave a link below.I hope this was helpful.

Festoons can be difficult to treat.  Some patients find improvement with laser treatments.  You may also consider FaceTite and Morpheus8 treatments.  See a board certified plastic surgeon to learn more.

HiOne of the most resistant problems plastic surgeons face are those malar pouches.  They resist surgery BUT you are on the right track.  Microneedling with radiofrequency (Fractora) has been very effective.  We also have had success with fat injections into this area.  The filler aspect of the fat helps conceal the pouches and the stem cells may actually improve the skin quality.  So the good news is they are improvable without surgery.Thank you for asking about this very common and annoying problem.Pamela R. Lipkin MD

Festoons can be very challenging to treat.  There are a number of options available that I have found success with.  Aggressive laser resurfacing, surgical release of underlying ligaments, skincare and microneedling are all beneficial for many patients.  For you, I would probably not recommend surgery because the festoon is rather small (compared to others I've seen) and likely doesn't need such an aggressive approach.  There is a somewhat experimental treatment that some of my oculoplastics colleagues have performed doing injections of doxycycline into festoons and have gotten great results. Doxycylcine injections are commonly used to ablate and remove cystic malformations all over the body including the face and eyelids/eye socket. I do not have specific experience with ultherapy as a treatment for festoons and therefore cannot comment on that, but I haven't heard about it at meetings or talks.  If I were you I would go with multiple treatments of ablative erbium or CO2 laser resurfacing, microneedling, and skin care. Be careful of filler because although they can help a lot of the time, I have seen filler make swelling slightly worse in some instances. Good luck!