Festoons (also known as malar bags or secondary eyelid bags)

are bulges on the upper cheeks that may swell and shrink over the course of the day.

Festoon Treatments

Malar festoons have a reputation of being a challenging condition to treat. They tend to reoccur after lower eyelid lift surgery. The most successful way to reduce or eliminate festoons involves a combination of procedures.

Dr. Kotlus advocates three techniques:

  • Volume replacement

    Festoons can appear when the cheeks and lower eyelids lose fullness due to aging.  Restoring lost volume to the areas around the festoon will smooth the cheek and soften the overall contour.  This can be done with filler injections or fat injections.  Fat is longer-lasting, but can sometimes require more than one treatment.

  • Laser skin tightening

    Laser resurfacing is helpful in tightening loose, crepey skin in the lower eyelid and upper cheek area and can firm the region around the cheek bag.

  • Skin and muscle lift

    A lower eyelid lift with muscle and skin tightening can further flatten the cheek mound, with a fine incision hidden under the eyelashes. This surgical procedure also releases and resets the ligaments under the eyelids, particularly the orbitomalar ligament.

Festoon correction with lower eyelid lift, fat injections, and laser skin resurfacing

dr. brett kotlus festoons fat laser

Festoon correction with lower eyelid lift, fat injections, and laser skin resurfacing

dr. brett kotlus festoons

For more details about festoons and cheek bag treatments:

Dr. Kotlus published a review of festoons in the American Journal of Cosmetic Surgery explaining the anatomy of festoons and treatments that have been described in the medical literature.  Click here to read his festoons review article.

Request a festoons consultation with Dr. Kotlus

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