Ask Dr. Naderi


Hi, I happen to have puffiness above my cheecks which I believe is referred to as malar bags. They seem to disappear when I smile. Is the puffiness caused by fat or water? Also, is there any way to treat this? I have looked up treatments online and it seems like there are no sure ways of resolving this and some surgens actually think it cannot be resolved <sigh>.

Have you ever successfully treated malar bags? If so, what techniques would you say are the best to employ and how long do the results last? I should also add that I am black and therefor suceptible to keloids. I am only 31 and this is making me look much older. My eye area is just fine, its only the malar bags.

Thanks in advance.

Sincerely,

Carol.

Posted on February 27, 2010 11:41 PM in General

Answer

Hi Carol,


It sounds like you have malar bags or pouches.  Typically when people talk about "bags" they are either talking about lower lid fat bags which true fat pockets pushing up against the thin orbital septum and eyelid skin (fat pseudoherniation) or they are talking about malar bags, which are areas of edema or fluid retention cause by a triangular zone of ligaments on the upper cheeks.  

True eyelid bags are treated with fat excision or fat re-draping alone or combined with skin excision (muscle can be removed too).  

Malar pouches are very tough to correct and there is no standard solution.  An extended lower lid blepharoplasty does help many patients but there is no guarantee it wont make it worse.  Injections of fillers around the malar pouches can help smooth and camouflage the pouches.  However, any irritation, be it lasers, chemical peels or aggressive injections of fillers can make the fluid retention or edema worse.  

See a few doctors and see what they would recommend in your particular case.


Ask a Question | Add Comment

Q&A Categories