Festoon Surgery

By Jerome Edelstein, MD

Once you hit 30 years old, the skin around your eyes becomes more wrinkled, puffy and baggy. You may find that bags develop under your eyes, and become more prominent with every passing year. Take a closer look at the bags under your eyes. Are they your lower eyelids or festoons? Determining which you have makes all the difference when selecting the right treatment to achieve your aesthetic goals.

Festoon VS Undereye BagsUndereye bags: This common aesthetic concern is caused by protrusion or herniation of fat that lies beneath the lower eyelid, something that occurs naturally with age. To make matters worse, your skin becomes less elastic as well, contributing to sagging. This is technically referred to as fatty orbital herniation. You’ve probably noticed that dark circles under your eyes have also appeared, something technically called arcus deformity. These are caused partially by a shadow created by the overhanging puffy eyelid.

Festoons: A festoon, also called a malar mound, is not located right under the eyes and isn’t associated with undereye bags. It is actually swelling on the upper cheek just below the lower eyelid, usually in the shape of a crescent. They are caused by sagging skin, damaged by excessive sun exposure, aging, smoking and other poor lifestyle habits. Festoons cannot be removed during a blepharoplasty since they aren’t related to the eyelids. As a matter of fact, they can sometimes become more prominent after a lower eyelid lift, which is why it is important that you consult with Dr. Fialkov, our craniofacial plastic surgeon, for an accurate assessment of your concern.

Festoon SurgeryTo remove festoons, the cheeks are targeted. A cheek lift, in which the offending skin is removed, is one way to remove malar mounds. In some cases, nonsurgical treatments can also be effective, such as laser skin tightening.