Dear Dr. Seckel, I have malar bags (festoons) one of which is at least twice as big as the other. I have been told that a blepharoplasty will not correct festoons. Do you know of any treatment to help improve this? I’ve been told direct excision is the only way to correct this, but due to the scar factor, no one I have consulted with is willing to do it. I would appreciate your expertise on this matter. Thank you in advance. Paula, Windsor, ONT.
Dear Paula,
Festoons, also called malar bags, the puffy area below the eyelids on the cheek are a very difficult problem to solve. The most common complaint about festoons or malar bags, arises after the eyelid rejuvenation procedure called blepharoplasty has been done to remove puffy eyes or eye bags from the lower eyelids. Following a lower eyelid blepharoplasty, especially if fat has been removed, the festoons often look worse, and patients notice them for the first time.
Direct excision of festoons is the contemporary standard however, as you point out, the scars are unacceptable.
There have been experimental results with laser resurfacing using the CO2 laser peel-but the recovery requires 3-4 weeks of redness. In addition although the festoon is tightened, long term the treated area is hypo pigmented, of a lighter color than the surrounding untreated skin
A newer method we are using and have had encouraging results with is skin tightening with Infrared or radiofrequency energy–there is no down time but 4-5 treatments are necessary spaced 4-5 weeks apart and a final result takes 6 months.
We have a new Radiofrequency skin-tightening machine, the Aluma with FACES which is designed to allow us to treat this specific small area of the eyelid, face and cheek.
For more information on lasers, eyelid rejuvenaation, and non-surgical facial rejuvenation read Save Your Face or contact me.
Boston, Massachusetts