32yo needing advice with malar bags. What would be the best option to see improvement?

Question

Hi I have recently had tear trough filler and although it has helped in the trough, I am still unhappy with my under eye area. I have been told that I have malar bags so adding anymore filler could make them look worse. I have also been advised surgery on malar bags is also extremely difficult. I was wondering what would be the best option to see a improvement, as you can see from pictures my under eyes are ageing me a lot Any advice is much appreciated

Jason Emer, MD · Answer

fillers, lasers, and plasma pen all help.

at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin roller with anteage MD ampules) should be started now.

There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term.  There are many things you can do to treat under eye hollows and dark circles without surgery.  Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture.  I suggest you get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Kenneth D. Steinsapir, MD · Answer

Rather than treating your tear trough, your injector treated the top of your cheek. This puts volume low in your cheek. That service will make you look older, not younger. This can happen even with Restylane which is the only filler I use in this area because it does not drift. Most of the fillers, however, are runny and drift down the cheek after placement. I would recommend removing all of the prior treatment and place a more accurate service.  These treatments are fussy which is why I see patient for fillers service from as far away as Dubai.

Camille Cash, MD · Answer

It's difficult to advise without knowing more about the filler placement.  Malar bags are not obvious in your photos.  Malar bags are difficult to treat, though some patients have improvement with Morpheus8 treatments.  These stimulate collagen production and improve overall skin tone and texture.

Robert T. Buchanan, MD (retired) · Answer

Without knowing exactly where the filler you head was placed, it is impossible to make a comment about the improvement, or lack of, that you had.  I suspect, though, that the filler was probably put in the wrong place since about 90% of the injectors treating this area do so. You have a classic syllable orbital ligament depression which is easily corrected with placement of a heavy filler like Juvéderm Voluma below that ligament.  This, however, requires a true expert in the area.  I would not consider surgery for your problem at your age.

32yo needing advice with malar bags. What would be the best option to see improvement?

Answers (4)

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