How can I get rid of under eyes bags? (photos)
Doctor Answers 3
Malar (cheek) crescents are a lesser from of malar festoons. It appears to be a small crescent on the tops of the cheeks with a groove beneath it. If the malar (cheek) ligament/groove were not indenting the skin, the cheek would appear to be a single unit without any shadows. The malar ligament below the malar crescent can make the crescent appear puffy, but it may also be more that the groove is making it look puffy.
Since you are so young, I'm not sure what I would recommend. For my older patient who have a more severe form of your same problem, I will ask for younger photos of themselves to see if it was there all along. If it was not, I feel confident that I can use injectable fillers deep under the indentation to pop them out. I have tried injecting the fillers right under the indentations like I do for smile lines, but filler can be felt on the surface of the skin and the indentations are still there. Using the deeper filling technique, I have had better success in popping out the malar ligament. By doing this, the malar crescent puffiness appears to blend in with the rest of the cheek.
I don't have experience with performing and extended lower eyelid surgery for malar crescent/festoons, so I will not make any comments good or bad about it.
The best way to fix it is an extended lower eyelid blepharoplasty. Less than that the only improvement will be with fillers in the depression and also augmenting the cheek bones as they will pull the skin upwards and backwards.
Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.