I am 25 years old with festoon/malar bags, what would be my best option?

Question

I had restalyn lyft in January but it didn't work as well as I was hoping. Please help

Adam Scheiner, MD · Answer

Dear Leah,Festoons and Malar mounds are difficult conditions to treat. I find that fillers tend to fix them in an pushed out fashion when really it would be better to have them flattened instead.I have had success using lasers to stimulate the body to tighten the skin in this area and improve the appearance of festoons and malar mounds.I'll include a video below.I hope this was helpful.

Kenneth D. Steinsapir, MD · Answer

This is a mid cheek groove.  It will not be fixed with lower eyelid surgery, laser resurfacing, or fat grafting.  This is a small problems that is best handled with hyaluronic acid filler is ideal for this.  However, it is a fussy service.  Only a tiny fraction of injectors are any good and dealing with this issue.  Your prior service might actually be making your issue worse.  A careful analysis needs to be done to determine if the old service needs to be removed or modified.  This is done with enzyme.  Once the tissues have settles (at least a few days) the correct filler service is then placed.  The right filler treatment make all the difference.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and photo. Festoons are particularly difficult to treat. Surgery is usually not a good option. Minimal improvement has been found with fillers, laser skin resurfacing and other techniques. Make sure to see an experienced Oculoplastic Surgeon for comprehensive evaluation and discussion of treatment options.  Good luck,

Jason Emer, MD · Answer

Lasers, RF treatments, fillers, and peels work best in this area.  You can get surgery or repositioning of fat to help along with RF / lasers. I suggest seeing an expert for a formal evaluation as a team approach may be best.  Best, Dr. Emer.

Elba Pacheco, MD · Answer

Thermage uses radiofrequency waves to heat and contract the collagen deep in the dermis. This causes an three dimensional tightening of the cheeks which can improve malar bags significantly. Give that consideration. Good luck

Andrea L. Dempsey, MD · Answer

Hello,

From your photo I think that you could be a good candidate for Radiesse in the cheek area to soften the malar area and festoon. Have you had tear trough injections with a HA filler? This is a great combination with the Radiesse in this cheek to help minimize the fold in the malar area that you are referring to. I have also used Sculptra in the cheek area with Belotero in the tear trough to give amazing results. I hope you find this helpful. Thank you for your questions.

Best,

Andrea Dempsey MD

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

Thank you for your question.  The surgical correction of malar bags is difficult and leaves significant scars.  For that reason I preferred dermal filler injections.  I would suggest trying fillers again but choosing a different provider and ask if they have had experienced treating malar bags.  Properly done the filler should help you.

I am 25 years old with festoon/malar bags, what would be my best option?

Answers (7)

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