Any treatment or solution for both festoons and eye bags? (Photo)

I have eye bags, and after doing some research, I've learned that I also have festoons. What is the best option available for me to get rid of them both. Looking back at pictures, I've had the eye bags since I was a little kid, but not the festoons. I've attached an image. The first lines are my eye lids, second lines are the eye bags, and third lines are the festoons.

Doctor Answers 1

Appropriate treatment for festoons depends upon how severe the changes are

Your history of developing these eyelid changes at different times of your life is consistent with the fact that these entities are caused by anatomically distinct structures and distinct processes.  Many times eye bags are as much a product of anatomy as they are age; festoons on the other hand generally result from a combination of advanced loss of tone and laxity in the support structures of the outer eye muscle, called the orbicularis occuli, and the fat pad beneath it (called the "SOOF - Suborbicularis Occuli Fat), as well as swelling and fluid accumulation, increased fat volume, or a combination of both.  When festoons are large enough, and skin excess and laxity are severe enough, we sometimes have to directly remove them with an incision right at the lid - cheek junction.  That is worst case scenario, though, and you are nowhere near that.  My expectation, based upon the one image you have provided, is that you would do very nicely with a lower lid blepharoplasty, including repositioning of your orbital fat, orbicularis muscle, and SOOF, together with a lifting and resuspension of your upper cheek fat to the orbital rim, or bony eye socket.  This is all done through the same incision, and it should blend the separating tissue planes as well as camouflage your bony orbit, and these things should address the concerns you have with your eyes.  If you wanted to be less aggressive, camouflaging simply with fillers or even fat grafting could be attempted, but my expectation is that things will still be left a bit "incompletely addressed," especially in the upper cheek and festoons.  Be sure to schedule consultations with board certified plastic surgeons, facial plastic surgeons, or occuloplastic surgeons to obtain a full evaluation of your eyelids and eyes, and that way you will also learn about all of the options available to you.  Best of luck.

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