I have these puffy fluid like pockets on both my cheekbones. I believe they are festoons? To me they are very bad. (Photo)

I would like to know what I can do to reduce the puffiness or to get rid of them completely?

Doctor Answers 5

How to treat festoons

Thank you for sharing your question and posting your photo. You have festoons, which are particularly challenging for doctors to treat. Options include direct excision which can leave a significant scar, steroid injection which can cause atrophy, laser resurfacing which is usually only minimally effective and Doxycycline injections which a few doctors have found to be successful. Make an appointment for comprehensive evaluation and discussion of possible treatment options.Good luck,

New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

I have these puffy fluid like pockets on both my cheekbones. I believe they are festoons? To me they are very bad

The most reliable way to remove them is to excise them. This will leave a scar where the festoon is at present but that scar usually heals well. Other methods have been tried but are not reliable/ predictable in their outcome

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews


This is swelling in the malar fat pad, and can be referred to as festoons.  Often with festoons there is also a thinning of the skin which you don't seem to have.  These are not easy to remove.  An extended lower lid blepharoplasty can elevate the whole area, and this can improve the contour.  Some laser resurfacing on top of them can also sometimes flatten them.  The difficulty is that this fat pad often can remain full after any trearment.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Lower eyelid festoons and malar mounds

Dear Patient from Virginia,
The swollen mounds you appear to have based on your photos are referred to as eyelid festoons and Malar Mounds. They are often related to sun damage over time to the skin in this part of the face. They can wax and wane and are more common in people with lighter skin types. 
I've had success using lasers to tighten and improve this condition. Other options include surgery to cut them out but this leaves a scar in this area. 
I hope this was helpful. 

Adam Scheiner, MD
Tampa Oculoplastic Surgeon
4.3 out of 5 stars 35 reviews

Festoons -- Laser, Fillers or Surgery

Lasers or fillers can help, but often surgery is the best option. I suggest seeking an expert for an in person evaluation. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

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.