Lower Eyelid Festoon: Causes and Treatment Options
A lower eyelid festoon, often referred to as ‘malar’ festoons, refers to a condition characterized by the presence of persistent swelling or puffiness in the lower eyelid and cheek area. These festoons can be frustrating for individuals who wish to achieve a smoother and more youthful lower eyelid appearance.
What Causes Festoons?
Festoons develop due multiple factors, with the main factor being the cumulative build up of sun damage from collagen breakdown on the lower eyelid and cheek region.
What Are Other Factors?
- Aging: The natural aging process causes the skin to lose elasticity, leading to sagging and the development of festoons. Collagen and elastin fibers weaken over time, contributing to this condition.
- Genetics: Some individuals may be genetically predisposed to develop festoons due to their family history.
- Fluid Retention: Fluid retention or edema in the lower eyelid area can cause swelling and puffiness that resemble festoons.
- Lifestyle Habits: Unhealthy lifestyle choices such as smoking, poor nutrition, and inadequate hydration can contribute to festoon formation.
What are Treatment Options for Lower Eyelid Festoons?
Treating lower eyelid festoons may involve a combination of surgical and non-surgical approaches, depending on the severity of the condition and individual preferences. Dr. Satterfield will guide you through your options to find the best solution for you.
- Lower Eyelid Blepharoplasty: Removal of a festoon is most reliably treated with direct removal of the excess tissue. This can be done alone or in combination with a total lower eyelid rejuvenation. To learn more about lower eyelid blepharoplasty click here.
- Laser Resurfacing: Laser treatments can help improve the texture and tightness of the skin. Fractional CO2 laser or erbium laser resurfacing can stimulate collagen production and reduce the appearance of festoons.
- Dissolving Dermal Fillers: Old dermal fillers placed in the lower eyelid or cheek region can contribute to puffy lower eyelids. If you have a history of filler in these areas be sure to mention it during your consultation.
- Radiofrequency (RF) and Ultrasound (Ultherapy): These non-invasive treatments can stimulate collagen production and tighten the skin in the festoon area. They are often used as alternatives to surgery or in conjunction with other procedures.
Are There Any Non-Surgical Options?
Mild festoons may respond well to radiofrequency microneedling (Morpheus8) treatment. This typically requires multiple sessions (at minimum 3) however advantages to this technique include minimal downtime. Unfortunately festoons don’t tend to respond well to topical creams. That being said, they can be minimized by reducing factors that cause swelling (such as high salt diet). Other products can be used to boost collagen such as topical retinoids (retinol) and vitamin C to improve skin collagen levels, and topical peptide creams to hydrate the skin.