Festoons and Malar Bags or Malar Mounds are puffiness below lower eyelids and above cheeks. They are very common and plastic surgeons are hesitant to operate on them, because of lack of operative success and high rate of complications.
Method: In the last 11 years, more than 100 patients had surgical correction of their festoons with great success and no major complications. Patients who are born with malar bags might need secondary procedures or off label use of Kybella injection to eliminate the localized fat that they had under the skin and over orbicularis muscle.
Results: All patients with festoons were corrected by lower blepharoplasty, release of retaining ligaments, mid facelift, canthopexy and orbicularis muscle suspension. The redundancy of the skin in the lateral eyes were corrected by shot scar temporal lift.
Conclusion: Pathophysiology of acquired and congenital festoons are different and successful surgical treatment of acquired malar bags that we call them Festoons are done with excellent results and high patient satisfaction.
