i'm a 39 yr old male with malar bags and lookreally tired what do you suggest? i've got these big puffy bags on my cheekbones. i've been thinking it was from years of sun tanning with no protection, althoughsomeone 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 startingto 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 somephotos with the different angles of the malar bags that are bothering you and you're askingabout options. well, this is a problem that
has evaded any type of consistent successfulapproach. you see, when we look at people with malar bags, we look at the most commoncauses that are associated. and so, the first questions i ask are sinuses, allergies, smokingand whether or not it runs in the family. malar bags represent an area which has fluidand that fluid is an area where things just get backed-up. it's almost like all the trafficgoing towards the tunnel and you're at the widest part of the traffic. you see, the sinusdrain to an area behind the eyeball, behind the orbit called the cavernous sinuses. andunfortunately, when there are conditions that cause the fluid to be static around the eyesor the sinuses, then the fluid tends to back-up and stay at the malar area.
now if allergies, sinuses and smoking arenot issues for you, the most likely, this is a more genetic problem. when people cometo me with this situation, i first take a step back and look at their face and eyesand 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 puffyareas around your eyes. now that puffy area around your eye is called lower eyelid fatprolapse. now, that is something that we can do about but i will only offer that as anoption to help you if you were equally concerned about the puffy area under your eyes comparedto the malar bags. what i always tell people, the eyes tell somuch about how you feel. there's a lot of
non-verbal communication and people who havepuffiness 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 tocome to us to look for some type of solution. so the options that have been tried for malarfestoons bags have included laser and peels. in our practice, i tend to avoid anythingthat 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 inflammatorycells. so unfortunately in interventions where there's heat, you can actually make the problemworse. it's almost the easiest ones is that festoons, we actually remove them.
some people that i've been able to help isby 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 fullfaced photos and ask the look of your eyes, not merely focusing on the malar festoonsbut also look at the under eye bags. if you are motivated the pursue the things that canbe done for and would actually yield a more predictable result. so i hope that was helpfuland thank you for your question.
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