What is a malar pocket?

They often form as a result of sagging orbicularis muscle, which may be associated with fatty melting of the cheekbone, which no longer supports the muscle.

It’s important to know that a malar sac is not made up of fat, but of lymph.

Causes of malar pockets

Treatment of malar pockets by Dr Hayot

Medical treatment of moderate malar pockets

In moderate forms, Dr Hayot recommends medical treatment to deflate the pockets:

• Delayed cortisone injection on the periosteum can act on the inflammatory component of the malar pocket.
• Hyaluronidase injection can significantly reduce edema.

Surgery for the treatment of pronounced malar pockets

The surgical procedure is more extensive than fat pocket removal. It combines a sub-palpebral lift to reattach the muscle and a lipostructure to fill the submalar hollow, which often contributes to the malar pocket.

The incision is made flush with the eyelashes. The submuscular facelift tautens the area by reattaching the excess muscle to the bone. In addition, Dr. Hayot performs cheekbone lipofilling (injection of fat taken from the patient’s knee or abdomen) to restore volume and ensure good tissue support.

Results of malar pocket treatment

The sub-palpebral muscle lift, performed to remove malar bags, is a delicate procedure. The orbicularis muscle must be perfectly re-tensioned to avoid damaging the nerve endings and the muscle, and risking postoperative ectropion (loosening of the lower eyelid). The surgeon must master the laser scalpel to make precise incisions along the ciliary margin. Excess skin must be removed in a measured manner to avoid deforming the eye and risking a round eye.

Because of its complexity, this facelift must be performed by an experienced surgeon. Ask Dr Hayot, a specialist in eyelid surgery in Paris.