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I'm a 39 yr old male with malar bags and look really tired what do you suggest?
I've got these big puffy bags on my cheek bones. I've been thinking it was from years
of sun tanning with no protection, although someone said it could be thyroid. What would
you suggest to fix them? Can they be "zapped" off with a deep aggressive laser treatment,
or maybe a lower bleph? They are really starting to bother me a lot. The photos are taken with
an overhead light.
Thank you for your question!
You're 39 years old and you submitted some photos with the different angles of the malar
bags that are bothering you and you're asking about options. Well, this is a problem that
has evaded any type of consistent successful approach. You see, when we look at people
with malar bags, we look at the most common causes that are associated. And so, the first
questions I ask are sinuses, allergies, smoking and whether or not it runs in the family.
Malar bags represent an area which has fluid and that fluid is an area where things just
get backed-up. It's almost like all the traffic going towards the tunnel and you're at the
widest part of the traffic. You see, the sinus drain to an area behind the eyeball, behind
the orbit called the cavernous sinuses. And unfortunately, when there are conditions that
cause the fluid to be static around the eyes or the sinuses, then the fluid tends to back-up
and stay at the malar area.
Now if allergies, sinuses and smoking are not issues for you, the most likely, this
is a more genetic problem. When people come to me with this situation, I first take a
step back and look at their face and eyes and try to understand the context of how we
can maximize the improvement of their appearance. The malar bags may have bothered you but something
you might not have appreciated is the puffy areas around your eyes. Now that puffy area
around your eye is called lower eyelid fat prolapse. Now, that is something that we can
do about but I will only offer that as an option to help you if you were equally concerned
about the puffy area under your eyes compared to the malar bags.
What I always tell people, the eyes tell so much about how you feel. There's a lot of
non-verbal communication and people who have puffiness under their eyes will often be perceived
as being tired or old or lacking in energy. And this has tremendous impact on the social
life or work life which will lead people to come to us to look for some type of solution.
So the options that have been tried for malar festoons bags have included laser and peels.
In our practice, I tend to avoid anything that adds heat to an area where in clinical
studies or in the basic science related studies, the pathology review of the fluid, often there's
a lot fluid because of inflammation or inflammatory cells. So unfortunately in interventions where
there's heat, you can actually make the problem worse. It's almost the easiest ones is that
festoons, we actually remove them.
Some people that I've been able to help is by using fillers to try to soften the transition
of appearance of the malar festoons but unfortunately, this is an area that can be frustrating.
So I would suggest that you take some full faced photos and ask the look of your eyes,
not merely focusing on the malar festoons but also look at the under eye bags. If you
are motivated the pursue the things that can be done for and would actually yield a more
predictable result. So I hope that was helpful and thank you for your question.