M37, what are my options for festoons/malar bags? (Photo)

Question

M37 . I have suddenly developed festoons/malar bags on both sides. They weren’t there a couple of months ago, but they suddenly showed up after a couple of stressful weeks. My dermatologist recommended a filler, but I heard that fillers make these things worse. What are my treatment options? P.S. there is also some pigmentation at these places. They are also more visible in some lighting.

Lexie Wang, MD · Answer

Filler will definitely make festoons worse, although I'm not totally convinced that's what those are based on your photos. The reason is that filler will draw more water into the area of the festoon. You can look at why you have them: possibly dietary changes (with the stressful weeks?), try some warm compresses+massage, and definitely work on your skin to help improve its resiliency and strength. A good aesthetician can help give recs.

Caner Kacmaz, MD · Answer

Hi!! This is Arzu from Dr. Caner Kaçmaz Clinic. The permanent problem for the puffy eyelids is lower blefaroplasty, We remove the excess skin and fat from the eyelid so you have a fresher and younger look.

J. Renee Booth, MD · Answer

For under eye discoloration, you can use a topical medication such as hydroquinone or tranexamic acid. There are medical grade products with these such as Alastin (A-LUMINATE Brightening Serum) and Obagi (Clear, Blender). Another option for discoloration of the face is broadband light treatment. The eyes must be protected during this treatment, so it cannot treat the entire eyelid. Using a medical grade moisturizer is very important because dehydrated skin may contribute to hollowing. Another helpful treatment in this region is radiofrequency microneedling. In some cases, patients do have under-eye hollowing and filler can help. If you move forward with filler around the eye, be sure that it is designed for the area (Belotero or RHA Redensity). Sometimes filler in the cheek beneath the eye is helpful for support (there are many fillers that can be used for the anteromedial cheek).
Your photo does not show your under-eye area while looking upward, which would be needed to evaluate for pseudoherniation of periorbital fat (protrusion of natural fat that cushions the eye). This would help determine if surgery would be useful in your case. A consultation in-person will allow a provider to tailor a plan to your unique situation.

M37, what are my options for festoons/malar bags? (Photo)

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