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Malar bags – Removal and Treatment

Malar bags RemovalWhat are malar bags or festoons?

Malar bags also referred to as malar bags or festoons are many a times not well understood. They are located on the upper corner of the cheek bone and are often confused with puffiness under the eye or under eye bags. Retention of fat or fluid directly in the under eye area is referred to as under eye puffiness. Festoons appear lower.

What is the difference between “festoons” and “bags”?

Festoons are mainly protruding on the upper part of the cheek, whereas bags are the result of fluid or fat protruding through the skin in the region of lower eyelid.

Bags generally occur as puffy circles directly under the eye. They are firm to touch, and can’t be moved from side to side. This is a clear indication that these are eyelid/malar bags. When you look up, they become prominent.

While, on the other hand, festoons are situated on the upper part of the cheek, however they can extend to the area of lower lid. These are spongy to touch and can move from side to side easily. They do not become prominent, when you look up.

What are the probable causes of bags and festoons?

Generally, bags are linked with allergies, ageing and fatigue.

Festoons usually result from damage. Smoking, exposure to sunlight, drinking coffee and alcohol, poor diet and ageing may be the responsible factors causing them. Also, blood pressure and circulatory issues may be a cause. It can get worse as a result of contrasting pull of underlying muscles of the face over the years. It is generally found to affect fair skinned people as compared to people having a dark complexion.

It is very likely that festoons are caused as a result of diet and lifestyle. For instance, those who are sensitive to caffeinated drinks, the festoons may enlarge or expand. Watching too much television and using too much of computer may also increase their size. Festoons become pinkish in colour and will either expand or reduce in size.

How are the malar bags treated?

Accurate diagnosis is the most important step. Bags in the under eye area can result from fluid accumulation or fat displacement. Difference between fluid or fat in the under eye area is extremely important since fat displacement is treated with blepharoplasty eyelid surgery, however surgery will in fact worsen a case of fluid accumulation. Laser skin resurfacing using fractional CO2 laser has yielded outstanding results in treating fluid accumulation.

Blepharoplasty Surgery

Cosmetic eyelid surgery such as Blepharoplasty helps to enhance the appearance of lower as well as upper eyelids. It imparts a young and refreshing look to the adjacent area of your eyes and makes you look more rested and alert.

Following ocular conditions can be managed with eyelid surgery:

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes leading to vision impairment, can be treated by eyelid lift surgery.
  • Upper eyelid surgery (Eyelid Lift / Eye Plastic Surgery) can remove excess fatty deposits that appear as puffiness in the upper eyelids.
  • Bags under the eyes can be rectified by blepharoplasty.
  • Lower eyelid surgery can correct droopiness of the lower eyelids, showing white below the iris (coloured portion of the eye).
  • Lower eyelid blepharoplasty can remove excess skin and fine wrinkles of the lower eyelid.
  • In some cases, the treatment of the eyelid bags and sagging skin can also cure/ treat/ remove the dark circles in the under eye area.

Blepharoplasty Surgery Treatment for Eyelid Bags & Eyelid Sagging (Eyelid Lift / Eyelid Lifting Surgery)

Blepharoplasty (Greek: blepheron, “eyelid” + plassein “to form”) is the plastic surgical procedure for rectifying the defects, deformities, and disfigurations of the upper and the lower eyelids; and for modifying the eyelid region of the face from an aesthetic point of view. With the excision and the removal, or the repositioning (or both) of excess tissues, such as skin and adipose fat, and the reinforcement of the corresponding eyelid muscles and tendon tissues, the blepharoplasty surgical treatment resolves aesthetic and functional problems of the upper and lower eyelids.

How is the Blepharoplasty surgery performed?

There are two ways in which the surgery can be carried out – through the eyelid skin or through the conjunctival (red) area of the eyelid. The scar post surgery (when carried out through eyelid skin) is concealed within the eyelid fold, whereas the scar cannot be seen in any case if the surgery is carried out using trans-conjunctival approach. Whenever involutional aponeurotic ptosis exists, the blepharoplasty surgery can be prformed along with a ptosis surgery in order to raise the eyelids.

Asian Blepharoplasty surgery (“Double eyelid” surgery) is a blepharoplasty procedure used to create a supratarsal eyelid (epicanthic) fold in the upper eyelid of the patient who lacks such an eyelid crease in the upper eyelid. The supratarsal epicanthic fold is common to most ethnic groups, but is absent in approximately half of the Asian ethnic races. This surgery is very common in people (Mongoloid races) from China, Korea, Japan, Singapore and parts of North-East India like Manipur, Mizoram, Nagaland, Meghalaya, Assam as well as Sikkim.

When choosing a surgeon to perform blepharoplasty surgery, look for a cosmetic and reconstructive facial surgeon who specializes in oculoplastic surgery and surgery of the orbit, eyelids, and tear drain system. Oculoplastic eyelid surgeons have obtained training in ophthalmology (eye surgery) and plastic surgery both, and hence are the best at treating the functional as well as the cosmetic aspects of eyelid diseases/ deformities in the most effective way.

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