Journal of Aesthetic & Reconstructive Surgery

Treatment of Malar Festoons by a Multifactorial Surgical Approach

Background: Periorbital changes are one of the earliest detectable signs of aging. Malar pathology with chronic edema, redundant skin and orbicularis, commonly described as festoons can present alongside a variety of lower eyelid pathology. Festoons present a challenge as they can exacerbate existing lower eyelid pathology and often recur after surgical treatment. The treatment of festoons thus must be multifaceted and address both the periorbital area and mid-face.

Objective: The authors report a case series of their approach for the surgical treatment of festoons by lower lid tightening, direct compression, and excision of the affected malar region. This rejuvenates the midface by minimizing tension and reducing downward forces on the lower eyelid while restoring a smooth contour from the lower eyelid to the cheek.

Methods: Twelve eyes of six patients with festoons were treated with lower lid tightening, direct compression, and direct excision of the affected malar region.

Results: All patients had successful results with this multifactorial surgical approach to affected malar region without any major complications. Patient and surgeon were satisfied with the results with minimal to no visible scar.

Conclusion: Our case series suggests that lower lid tightening, direct compression, and direct excision of the affected malar region is an effective, predictable, and safe therapy.

Author(s):

Brian M. Smith^1,3*, Sarah G. Bonaffini^1,3, Usma Chatha^2,3 and Jacqueline Carrasco^2,3

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