Malar Bags: What Are They, Causes & Treatments

Faces are particularly vulnerable to cosmetic problems, as even the slightest change can be pronounced and dramatic. The malar bags are one example of this. While many people commonly refer to them as “eye bags,” they’re not the same as them and need to be treated differently. 

What Are Malar Bags?

A malar bag is a swollen mound that appears at the junction between the lower eyelids and upper cheeks. It can, however, extend to the cheeks themselves. You can see and feel them under the bony rim of the orbit, below the eye bags. 

Another name commonly used for malar bags is festoon, which is a word used to describe the hanging of things between two points. Malar bags are also described as “hammock-like” sagging of the orbicularis oculi muscle. However, it’s not just the loosening of muscles that causes it. It can develop due to fluid retention, fatty tissue, and excess skin. It has three different presentations: 

  • Malar Edema: It develops due to the accumulation of fluid in the malar area. Eating a lot of salty foods can make it more prominent. 
  • Malar Bags: This is a chronic swelling of the malar area. In addition to fluids, there may be excess tissue. 
  • Festoons: This is the most severe form in which the skin is cascading downwards. It can occur due to a combination of skin laxity, drooping and protruding fatty tissue, and fluid collection. It is commonly seen in adults. 

Therefore, the treatment for this condition varies depending on the underlying cause. 

These can be seen in young as well as older people. Keep in mind that these don’t appear overnight. They become more and more prominent over several years as the person ages. 

What Is The Cause of Malar Bags?

The malar bags may be a result of a genetic predisposition to them. They can run in families. However, it can occur due to a combination of other factors like ageing, tissue atrophy, gravity, and skin laxity. 

Another cause of it is also the loss of fat, which can make the underlying structures more prominent. People who exercise more may experience that. However, there are other things that can temporarily result in this condition, such as the intake of steroids or NSAIDs, allergies, skin conditions, and illnesses. 

What To Expect At The Doctor? 

The doctor will determine that by asking questions about your lifestyle. That’s because smoking, salty foods, and sleep habits can make them more noticeable. In addition, you will also be asked about any history of thyroid, sinus, kidney, liver, or heart problems, as they can also cause eye swelling. 

Age is also taken into consideration. That’s because the supporting structures in the skin degrade with time, and it can cause the protrusion of underlying fat pads. Because the skin in the area is so thin, this change is quite prominent. 

A pinch test can also be performed to determine the cause of the problem, whether it’s muscle, fat or fluid. The doctor will pinch the skin of the malar bag in different areas as the patient makes different expressions simultaneously. 

How To Get Rid of Malar Bags? 

Your doctor may recommend the following surgical and non-surgical procedures for the treatment of malar bags: 


One of the most popular treatments for malar bags is fillers. It does so by filling up the area around the festoons. This helps raise the skin so that the malar area doesn’t jut out abnormally. Therefore, it doesn’t rid you of the problem but takes care of it by making some cosmetic tweaks in the area around it. 

However, keep in mind that fillers are temporary and can last anywhere from 6 months to 2 years. Also, this treatment is usually recommended for younger patients who only have a mild case of this condition. 

Laser Skin Resurfacing 

Another treatment for malar bags is laser resurfacing. It essentially injures the skin to stimulate the production of collagen, which, in turn, tightens the skin. This can help make the festoons less prominent if skin laxity is the problem. 

Again, keep in mind that laser resurfacing won’t completely rid you of the malar bags, and the best results are seen by those who only have a mild problem. You may be recommended dermal fillers in addition to this. 


This is known as eyelid surgery, where the surgeon aims to get rid of under-eye bags or ptosis (droopy upper eyelid) by getting rid of excess skin, tightening the underlying muscles and repositioning the fat pads. In the case of malar bags, it will be performed on the lower eyelids and can address the condition as far as fatty tissue is the problem. 

If done correctly, the surgery should not cause malar bags, which is a concern among patients. However, it can occur temporarily because of post-op swelling. Malar bags are not easy to treat, so make sure to get in touch with a board-certified specialist plastic surgeon. 


Since malar bags affect the cheek area, you can consider getting a mid-facelift. This can help if the malar bags are a result of excess skin tissue. By getting rid of excess skin and tightening it, their appearance can become less prominent. However, keep in mind that it’s not always recommended because it’s considered a more aggressive approach to the problem. 


Malar bags resulting from the presence of excess fat can also be treated through liposuction. Research has shown that it can be an effective treatment for it. In this, the surgeon will insert a small cannula for suctioning the fat out until it no longer protrudes. Since the surgery requires a lot of precision and care, you need to be very careful about your choice of surgeon. 

Direct Excision 

This is recommended in the cases of severe festoons. When there is too much skin and muscle, it is simply excised or removed. The surgery will require incisions, and it can leave prominent scars. That is why it is more commonly recommended to older patients since the wrinkling of the skin can better hide them. 

This surgery can effectively solve the problem, though. If you’re thinking of undergoing this procedure, it’s best to look at some before and after photos of some other patients so that you can get an idea of the scarring. 

How To Tighten Malar Bags Naturally?

In order to tighten malar bags naturally, some people recommend performing facial exercises. They may, however, only be effective if the problem is loose muscles. Exercises can help tone them, but if the festoons are too severe, they are unlikely to work.

As malar bags can become more apparent due to certain lifestyles and dietary habits, some people also use cold compresses to reduce swelling. However, they can only provide temporary relief. You should not expect cold compresses to tighten the malar bags naturally. 

Other than that, if you see any lotion, cream or gel marketed toward people with malar bags, it’s likely a hoax because it cannot work. Tretinoin is recommended as one potential solution to the problem as it can also stimulate the production of collagen. However, the results from this might just be negligible. 

Are Malar Bags Permanent? 

Malar bags are permanent. However, they can be temporarily treated with non-surgical solutions. You can only get rid of them permanently through surgical interventions. Trying out any natural or at-home technique for this is unlikely to work. And you can only expect these to get worse with time. 

How Can You Prevent Malar Bags?

It may not be always possible to prevent these as genetics and ageing are at play. However, you can do the following to prevent them from becoming more prominent: 

  • Reduce sun exposure and wear a sunscreen 
  • Avoid/quit smoking 
  • Get a good night’s sleep
  • Avoid consuming too many salty foods and alcohol 

Keep in mind that these things won’t help you reverse any existing malar bags that you have. 


Malar bags are swollen mounds or lumps of skin that appear in the area between the lower eyelids and upper cheeks. These are soft to touch and can protrude from the skin in a way that causes aesthetic discomfort to many people. Unfortunately, they are permanent, and there’s no way to get rid of them naturally. However, you can get them treated through surgical and non-surgical interventions. Fillers are one of the most popular treatments for this problem. 

They don’t treat the underlying problem, but they make the skin even by lifting it up to match the height of the festoon mound. Surgery, on the other hand, offers a permanent solution to the problem. You may be recommended the most suitable option depending on your skin type, age, and severity of the malar bags. However, you need to make sure to find a good surgeon. After surgery, you should also keep in mind that temporary post-op swelling can make it look like your malar bags have worsened. But it should get better with time.

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