Malar bags / festoons

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.