44, malar bags worse after hyaluronidase & Morpheus! Help (Photos)

Question

Over the past 3-4 yrs my malar bags have become more apparent (but nothing that bothered me, tbh). I just turned 44. I’m going to a PA and she gave 4 weekly injections of hyaluronidase and then we did one Tx with Morpheus (“festoon setting”). They are worse than ever before. I’m at a loss at what to do! Why would either of those make it worse?? I had tear duct filler about 3 years ago but that was dissolved and the malar bags were not worsened. It has only been the last 2-3 months…TYSM

Nelson Lee Novick, MD · Answer

Given the history of prior tear trough treatment with a hyaluronic acid filler it is possible that this is what has been called "under-eye puffy pillows," which can result from prior treatment in the infraorbital region with an inappropriate for the area HA filler and/or which had been injected too superficially leading to lymphatic obstruction (lymphedema). If so, this can be a particularly difficult problem to treat. I have had success, however, employing an algorithm of consisting of varying combinations, concenrations and amounts of iintralesional  anti-inflammatory agents. As you have alraedy found out this type of problem seldom responds to simple hyaluronidase injections. And, as you have also learned, fancy-named and relatively expensive RF gizmos, much like fraxel lasers, lack the hard science to back up the heavy marketing hype and social media buzz that surrounds them. You would be wise to consult a board certified cosmetic dermatologist. Best of luck and Happy New Year.

Lawrence Kass, MD · Answer

I am sorry that you had hyaluronidase and morpheus and that these options provided no relief from your malar bags which are now worse than ever.  There are no great or easy treatments for malar bags such as yours.  The only nonsurgical option you might consider is doxycycline injection (but this too carries risks and ultimately might make future surgical repair more difficult).  I would avoid fillers and fat transfer and thread lifting.  If everything else fails, the good news is that there are surgical options available which may be very helpful when done by surgeons most experienced with these techniques.

Darryl J. Blinski, MD · Answer

As seen in your posted photos the malar bag issue has been addressed but I might have done micro KyBella injections in 3 sessions every 3-4 weeks. If that does not help then a cheek lift surgery. Best to virtual consult with ….

44, malar bags worse after hyaluronidase & Morpheus! Help (Photos)

Answers (3)

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

44, malar bags worse after hyaluronidase & Morpheus! Help (Photos)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.