What Causes Eyelid Bags? Analysis of 114 Consecutive Patients

Goldberg, Robert A.; McCann, John D.; Fiaschetti, Danica; Simon, Guy J. Ben

doi:10.1097/01.prs.0000157016.49072.61

Cited by 131 publications

(102 citation statements)

References 19 publications

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“…This is more common in patients older than 50 years of age [13,15]. Gravity seems to have little effect on the development of malar mounds.…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

“…4) often relates to the underlying bony structure and is particularly associated with age-related maxillary hypoplasia, in combination with the loss of subcutaneous fat with thinning of the skin over the orbital rim ligaments and cheek descent [13]. There is still controversy as to whether treatment for the herniation of fat in palpebral bags is best-determined, together with the presence and severity of a tear trough deformity or without the consideration of tear-trough deformity.…”

Section: Palpebral Bagsmentioning

confidence: 99%

“…Additionally, eyelid fluid moves and gathers below the orbital rim as we press on the orbital rim, whereas infraorbital fat does not move [13]. Festoons are composed purely of skin and the orbicularis oculi muscle that can accumulate fat or fluid, forming edematous sacks that bulge from the area of malar eminence [1].…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

“…This should be distinguished from the protrusion of orbital fat against the weakened orbital septum or orbicularis muscle in the case of palpebral bags, in which the infraorbital fat is instead separated by the arcuate expansion of the inferior oblique laterally, and the valley of the inferior oblique medially and eyelid fluid has an even contour that does not respect the orbital compartments in its distribution [13].…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

“…Other exacerbating factors include a salty meal (due to increased sodium intake), systemic edematous state (e.g. chronic renal disease, allergy, or hepatic cirrhosis), or drug use [1,13].…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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The ill-defined lid-cheek junction continues to be one of the most challenging regions for rejuvenation. Malar mounds, festoons or palpebral bags, may occur alone, or in combination, in the infraorbital area. These pathological variants are distinctly different and may contribute to patients' perception of their eyebags. Traditional lower blepharoplasty (fat repositioning/ removal) with skin adjustment alone may be insufficient in addressing all of these pathologies, and recurrence may occur. This literature review aims to look at current definitions and treatment of festoons, malar mounds, and palpebral bags in Asian blepharoplasty. A Medline literature search for articles with anatomic descriptions of malar mounds, palpebral bags and festoons, particularly in Asian eyelids, was performed. This was supplemented by a manual search of the references of articles obtained. The details of all of the different surgical options for eyelid rejuvenation are beyond the scope of this review article. Thus, only the basic concepts that illustrate the anatomical relationship and the natural progression of malar mounds, festoons, and palpebral bags will be discussed in this article. Some of the treatment options, both invasive and non-invasive, will also be reviewed. There is no singular treatment for malar mounds, festoons, and palpebral bags. Standard lower blepharoplasty with skin excision is ineffective to lift and re-drape malar mounds or festoons. Repositioning of the malar septum, on the other hand, allows for resolution of the edema (malar festoons) above its cutaneous insertion. A number of liposculpturing techniques to volumize deficient areas, such as fat repositioning (cheek, suborbicularis and descended malar fat pad) with lifting of the midface, can be beneficial to restore a smooth lid-cheek junction.Non-invasive techniques like laser resurfacing and Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) may be useful in periorbital rejuvenation in selected cases.

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“…This is more common in patients older than 50 years of age [13,15]. Gravity seems to have little effect on the development of malar mounds.…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

Section: Palpebral Bagsmentioning

confidence: 99%

Section: Festoons and Malar Moundsmentioning

confidence: 99%

Section: Festoons and Malar Moundsmentioning

confidence: 99%

“…Other exacerbating factors include a salty meal (due to increased sodium intake), systemic edematous state (e.g. chronic renal disease, allergy, or hepatic cirrhosis), or drug use [1,13].…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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Orbicularis Muscle Position During Lower Blepharoplasty With Fat Repositioning

Couch

Buchanan

Holds

2011

Archives of Facial Plastic Surgery

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Orbicularis Muscle Position During Lower Blepharoplasty With Fat Repositioning

Couch

Buchanan²,

Holds³

2011

Arch Facial Plast Surg

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The orbicularis oculi muscle fusion to the maxilla below the arcus marginalis defines the junction between the eyelid and the cheek, and it provides an anchor for the tear trough. The eyelid-cheek interface is significantly elevated with our surgical technique of fat repositioning in the supraperiosteal plane. Elevation of the orbicularis muscle edge may contribute to improved blepharoplasty results in treating the aging midface.

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What Causes Eyelid Bags? Analysis of 114 Consecutive Patients

Abstract: Eyelid bags do not have a single anatomic basis. For different anatomic problems, different treatments are recommended.

Cited by 131 publications

References 19 publications

The troublesome triad: festoons, malar mounds, and palpebral bags

The troublesome triad: festoons, malar mounds, and palpebral bags

Orbicularis Muscle Position During Lower Blepharoplasty With Fat Repositioning

Orbicularis Muscle Position During Lower Blepharoplasty With Fat Repositioning

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