Is ThermiTight an option to treat malar bags?

Malar bags are often used as a term to describe festoons, which are areas of water retention below the crease (tear trough) of the skin below the eyelid and situated over the cheek bone. These must not be confused with herniated fat pads. Malar bags are not water baloons that can be "popped" to express the water. Surgery may not be curative and in some cases could cause lymphedema or more swelling. There has been mention of improvement of festoons with ThermiTight. The radiofrequency delivered through a small cannula under the skin to the swollen area creates heat which may help collapse the swelling. No one is certain as to the cause of the festoon so no one can be certain as to why the ThermiTight actually helps. This is a relatively new treatment and one should tread cautiously. less is more. One can always go back and do more but with newer treatments it is wise to be gentle at first.

An exam by a board certified physician with experience with this technology is in your best interest. Malar Bags also called festoons are a difficult area to treat by any method. Laser treatment may offer the best result, but TheriSmooth (topical RF energy to tighten the skin) may also  be a safe and effective option. I do not know of anyone with significant experience or any articles written about ThermiTight treatment of this area - I would proceed with caution regarding placing a RF heating probe in this area.

The term malar bags or swelling below the rim of the orbit refers to the little pocket of tissue over the cheek also termed a malar crescent. This early crescent when left untreated will turn into a festoon. We have developed a protocol utilizing Thermi that is effective for contracting this swollen tissue. It is interesting that the full results may not be evident for up to 6 months after treatment. Thermi usually shows improvements in treated tissue at 3-4 months? These types of thermoplastic treatments are an exciting new option for patients and surgeons.

True malar bags have been a challenge for surgeons to treat.  Over the years, a number of methods have been described - which tells you that we haven't found the perfect answer yet!The ThermiRF machine is very versatile.  Some surgeons have tried it on the malar bag area, and have anecdotally reported good results.  So - it's promising, but "still under investigation", at this stage.

Thermitight is not the appropriate procedure to treat malar bags. Instead, Thermismooth has much more potential to treat this region of the face. It is a handpiece that heats the skin and underlying tissues from the surface and can cause great results for skin tightening around the eyes.

The Thermi machine is very versatile and I have been using it extensively in my practice. One of the things I love about the machine is that it can be used in small localized areas like around the eye or even larger ones such as the neck and jowl region. In your case, pictures would be helpful as we have to differentiate herniation of the fat that surrounds the eye vs. malar bags or festoons.

I have been asked this question many times. One of the exciting things about the technology is that while it is most commonly used in the neck and cheeks, it can be applied in like tissues in various locations in the body.Malar bags, or festoons, are an evolving area of expertise, an exciting new area of interest, for ThermiTight doctors. The temperature controlled radio frequency of this technique has been well established in the neck and cheeks over thousands of cases. The mechanism appears to include collagen tightening and cross-linking as well as stimulation of new collagen formation. The device is approved for use in soft tissue, so doctors have begun to apply it widely throughout the body in the soft tissue - the face, cheeks, neck, arms, banana roll and many other areas. With the same mechanism in play, it is natural to consider other areas like festoons. It is very clear that connective tissue and collagen tightening of the fibro-septal network occurs during a ThermiTight procedure. At higher temperatures fat can be addressed as well. This selectivity is one of the great strengths of ThermiTight. Varying the settings allows treatment of various tissues in the same session. The smaller 22 gauge probe is preferred around the eye and it only takes a few minutes on each side. Results generally begin to show in the first few weeks or month and continue to improve for several months afterwards. They can last for several years at least.The best approach is to work closely with your doctor, and if there is any concern, try a small test area first.

This is a great question without a definitive answer since it is still too early for the use of this treatment for this condition to evaluate results, risks, and longevity. Theoretically, there should be some benefit, but proper protocols regarding temperature settings and recovery have not been established. Other alternatives include fractionated CO2 laser peel with volume replacement of the cheeks. Always look at before/after photos and talk to patients personally before deciding on a particular treatment. Hope this helps.