can be very aggravating and challenging to eliminate. As mentioned, you could go with resurfacing in an attempt to shrink the skin but more reliable would be using ThermiLift to tighten the skin from a percutaneous approach. Microliposuction used to be attempted but I wouldn't waste time with that.
Hi. You do appear to have lower eyelid festoons. These can be very difficult to treat. Surgical correction, laser resurfacing, and chemical peels are all options that have varying degrees of success. Injecting the festoon with tetracycline may also help. Make an appointment with an oculoplastic surgeon for an in person examination to determine your best options. Best regards, Ira Vidor, M.D.
Thank you for your question and photographs. Festoons are very tricky and resistant to treatment since they are often caused in part by collection of fluid and swelling which is difficult to eradicate. In your case I would recommend CO2 fractionated laser peel to tighten the skin. This may not remove the festoons completely but can be repeated if necessary and should provide noticeable skin tightening and improvement. Most difficult cases respond best to direct excision leaving a small incision line in that area.
Discuss this with your board-certified plastic surgeon or oculoplastic surgeon before proceeding. Best wishes and good luck.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California
Malar festoons after lower blepharoplasty
these are very difficult to correct. You essentially have two options one is direct extension which will leave a scar. The other is a deep Phenol peel which heals in 10-12 days and should be done by a very experienced surgeon with this technique.
Malar festoons have several options for improvement. Often we can camouflage them with fillers above and below. Second option is deep chemical peel or CO2 laser resurfacing. Lastly, I have had success with direct excision for really tough ones.
I personally you recommend a chemical peel to resolve this issue.
This can be fixed with lower eyelid surgery but that is a pretty extensive surgery. Alternatively, a phenol 89% chemical peel is highly effective at shrink-wraping the extra skin in the festoon. Typically the skin is intact after about 1 week of healing and able to hold makeup at about day 8. My ebook cited below has information on how this is performed.