Malar bags / festoons

Dr Christian Köhler

Practising Doctor, MBA, Diploma in Health Economics, Certified Consultant and Managing Director

Constant training and development

Many years’ experience in cosmetic surgery

Extensive consultation and planning

Facts about malar bags / festoons

Treatment durationApprox. 20 minutes (fillers), approx. 60 minutes (surgery)
AnaestheticLocal anaesthetic (fillers), general anaesthetic if required (surgery)
AdmissionOutpatient (fillers)
Follow-up treatmentCooling for 1–2 days; in case of surgery, sutures removed after 5 days
PresentableImmediately (fillers), after 7–10 days (surgery)
ExerciseNext day (fillers), after approx. 2 weeks (surgery)

Although most people might thing they look like nothing more than bags under the eyes, such issues can sometimes turn out to be malar bags or festoons. Swelling and wrinkles in the region below a person’s eyes can make their face look tired and older than they are. But it doesn’t have to be this way. Professional treatment can reduce such issues and optimise your appearance. A range of treatment methods can be used here depending on the patient’s specific situation, from outpatient hyaluronan injections to surgical procedures. Dr Köhler can hold a personal consultation with you here at the prevention-center in Zurich to discuss whether you would be a suitable candidate for this treatment and which method would be best to reduce your malar bags and festoons.

Benefits of malar bags treatments at the prevention-center in Zurich

  • Years of experience in cosmetic surgery
  • Detailed personal consultation meeting
  • Individual treatment plans
  • Treatment in line with the highest hygiene and quality standards

FAQs about malar bags

Malar bags is the term for bulging areas of swelling along the cheekbone. This is caused by deposits of fatty tissue and/or accumulations of water that have begun to sag due to weak muscles or a lack of tautness in the skin. Despite their visual similarities, malar bags – also known as cheek pouches – differ from bags under the eyes, which are higher and closer to the eyes.

There are various possible causes of malar bags: in addition to genetic predisposition that comes to light in the course of the natural skin ageing process, another common cause is weak connective tissue. A person’s lifestyle is another influencing factor, as sun-damaged skin, poor nutrition, alcohol, nicotine, stress and insufficient sleep can all lead to malar bags forming. Malar bags are sometimes side effects of colds or allergic reactions. In very rare cases, they are a symptom of a more serious condition.

Malar bags and eye bags appear similar at first glance, which is why people often confuse or conflate the two. The difference, however, is that eye bags are directly below the eye, while malar bags are located on the cheekbone – below where eye bags form.

Hyaluronic acid fillers are usually a suitable and sufficient treatment for mild malar bags. These targeted injections slightly bolster the cheeks and thereby compensate for any volume differences. This leaves the patient’s face looking fresher and younger. Alternatively, fat tissue can be removed using fat-dissolving injections.

However, these methods are usually not sufficient to treat more pronounced malar bags. Such cases require surgery to treat the swelling. In this procedure, known as an extended lower-lid blepharoplasty, a delicate incision is made on the cheekbone in order to remove excess fatty tissue and firm up the skin in the cheeks. In some cases, it also makes sense to strengthen the muscles to lift and rejuvenate the entire cheek area. Dr Köhler offers both treatment methods at the prevention-center in Zurich.

The treatment duration depends on the treatment scope and can vary from patient to patient. In our experience at the prevention-center in Zurich, filler treatments take around 20 minutes. Surgery takes somewhat longer and usually lasts around 60 minutes.

After a filler treatment, you will be presentable straight away. Any slight redness or small bruises around the puncture sites can be effectively covered with make-up until the symptoms recede. You can support the healing process and reduce the risk of swelling by carefully cooling the affected area after the treatment.

If you undergo surgery to remove your malar bags, you should carefully cool the affected area on a regular basis in the days following the procedure. Any wound pain can usually be effectively treated using standard painkillers. We will hold a check-up appointment at the prevention-center in Zurich 5 days after the procedure to remove the sutures. Until then, you should take the time to rest and recover. Do not engage in strenuous physical activity such as sports or exercise for 3 weeks and avoid direct sunlight and visits to the solarium or sauna for at least 4 weeks.

That depends on the type of treatment. After filler injections, you will be presentable straight away, enabling you to leave the prevention-center immediately and go about your normal daily routine. If you undergo surgery, you should allow a period of 7–10 days to recover.

Hyaluronic acid injections and fat-dissolving injections do not entail considerable risks. Slight redness, minor bruising and swelling can occur around the puncture sites, though such symptoms should disappear on their own very swiftly. Some patients experience a burning sensation around the injection sites, though this is also only temporary.

Surgical treatments for malar bags are also low-risk procedures – when performed by experienced surgeons such as Dr Köhler at the prevention-center in Zurich. Like all surgical procedures, especially those performed under general anaesthetic, there are general surgical risks such as secondary haemorrhages, wound-healing disorders and infections. However, you can minimise these risks by choosing an experienced surgeon who works to the highest hygiene and quality standards. You will receive detailed information during your consultation.


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