top of page
AEnB2Upg7CH-BTt7zqngk3XyR20Dqow3rzZ0D6QpTyEEKNGkDvcxEKeMsJC5a0hVdktRrZKKwBTXx1We92aWEtVgzN

Surgical Treatment of Festoons (Malar Mounds)

IN SAN DIEGO

1

What Are Festoons?

Also known as malar mounds, festoons are puffy, bag-like formations that appear on the lower eyelids and upper cheeks. Unlike typical eye bags, festoons are deeper and more pronounced, often imparting a tired or prematurely aged appearance. These formations can significantly impact facial harmony and self-esteem.

Causes & Risk Factors

Festoons are multifactorial in origin, with several contributing elements:

Genetics – a family history often predisposes individuals.

Aging – reduced skin elasticity and fat shift enhance festoon formation.

Sun Exposure – UV damage accelerates skin laxity.

Lifestyle – smoking, excessive alcohol, and unhealthy diet exacerbate puffiness.

Medical Conditions – chronic sinusitis, allergies, and fluid retention can worsen the issue.

 

Why Festoons Are Difficult to Treat

Festoons represent a complex combination of skin laxity, fat displacement, and fluid retention, which makes them resistant to one-step treatments. An effective solution demands a customized, multi-modal strategy tailored to each patient.

 

Effective Treatment Options​

1. Surgical Excision
Direct removal of festoon tissue restores lower eyelid contour and resets facial balance.

2. CO₂ Laser Resurfacing
Targets skin tightening and texture improvement post-surgery, reducing wrinkles and scarring.

 

3. Injectable Therapies (e.g., 5‑Fluorouracil)
Adjunctive 5‑FU injections can soften tissue and minimize scar formation after surgical excision.

 

4. Additional Non-Surgical Treatments
Chemical peels, microneedling, and radiofrequency can support overall skin rejuvenation.

 

Case Example: Combination Approach

This lovely patient with pronounced festoons underwent a three-part treatment:

  1. Surgical excision to remove excess tissue.

  2. 5‑FU injections to refine and soften scar tissue.

  3. CO₂ laser resurfacing to tighten skin and smooth contour.

 

Outcome: A visibly smoother, youthful lower eyelid and cheek area—with significant reduction in puffiness and improved skin texture.

Benefits of a Combined Treatment Plan

  • Comprehensive Result – Addresses both structural and skin-level concerns.

  • Customized Care – Tailored approach ensures optimal outcomes for each facial anatomy.

  • Enhanced Recovery – Synergistic effect of surgery and adjunctive therapies yields smoother healing and minimal scarring.

Who Is an Ideal Candidate?

Ideal candidates typically present with:

  • Moderate to severe festoons noticeable at rest

  • Skin laxity and cheek fullness

  • Realistic expectations and willingness to undergo surgical and post-operative therapies

A personalized consultation is essential to determine suitability and expected outcomes.

Disclaimer: This information is not intended to replace a medical consultation, nor does it constitute a doctor-patient relationship. Each individual’s treatment and/or results will vary, and no guarantee is stated or implied by any photo or statement used on this website.

Surgical Treatment of Festoons Consultation

 

If you are bothered by festoons and are considering surgical excision, and would like to have an in-person consultation with Dr. Abboud, please contact us to schedule an appointment and learn more. 

Consultation
bottom of page