I'm hoping for a non-surgical option for malar bags & rosacea? (Photos)

Question

Help - I’ve got terrible malar bags, made worse by rosacea which makes the bags redder than the rest of my cheeks and thus more noticeable. The bag under my right eye is significantly worse and causes an indentation when I smile. I can’t afford surgery so I’m hoping for a nonsurgical option. I’m getting Excel V for the rosacea soon - will that help? What fillers are best for this?

Jason Emer, MD · Answer

you need fillers, lasers or plasma pen in office.  at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin roller with anteage MD ampules) should be started now (see link). a lower eyelid surgery will give most permanent improvement.

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.

Nelson Lee Novick, MD · Answer

I literally just had a patient this morning who came up from North Carolina with exactly the same issue. Volume loss in the upper cheek regions is largely responsible for the tear trough and malar bag formation (as well as for the smile lines (and to some extent also the marionette lines) seen in the photos, as well. Simply performing a filler cheek augmentation with Voluma XC or Restylane Lyft, by revolumizing and providing lift to the the upper cheek will very likely lead to a considerable improvement both in the under eye regions and the smile lines. It's difficult to say from the photos, but more likely than not, your rosacea can be easily handled with appropriate at-home prescription topical agents, rather than investing in heavily marketed and expensive bells and whistles laser treatments. Make sure to consult with a board certified aesthetic dermatologist who can help you with both issues. Best of luck.

Leonard Grossman, MD · Answer

You do not have malar bags. What you perceive as malar bags is a normal presence of one of the fatty compartments of the cheek. What you’re missing is the inner portion of the cheek as well as the lower eyelid area. Even what looks like a bag in the lower eyelid is actually nothing more than bone of the eyesocket. Just go in front of the mirror and touch it. Your condition is purely hereditary and most likely has been inherited from your father who has a rather hollow appearing cheeks. This condition can easily be treated once and for all with fat grafting. When fat grafting is performed by a plastic surgeon with a great deal of experience in such techniques, the results are natural and permanent. I hope this helps and good luck from New York City plastic surgery

Robert T. Buchanan, MD (retired) · Answer

You have deflation of your malar area with a "V" orbital ligament causing what you call "malar bags." Treatment is use of a heavy filler like Juvederm Voluma or fat placed deep under the different ligaments by an expert. The rosacea is telangiectasia, an abnormal collection of capillaries from sun damage. For this you need to be using daily zinc oxide sunblock to prevent further damage and use of an IPL to eliminate the redness.

I'm hoping for a non-surgical option for malar bags & rosacea? (Photos)

Answers (4)

Answer: Treatment of Malar Bags & Rosacea

Answer: Treatment of Malar Bags & Rosacea

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I'm hoping for a non-surgical option for malar bags & rosacea? (Photos)

Answers (4)

Answer: Treatment of Malar Bags & Rosacea

Answer: Treatment of Malar Bags & Rosacea

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.