Treatment of malar bags

Solutions for the treatment of malar bags

From a therapeutic point of view, there are two approaches, depending on whether the malar bag is early and moderate or very pronounced. In moderate forms, medical treatment by injection is usually sufficient.

My technique combines several methods to deflate the bag:

• A slow-release cortisone injection, down to bone contact, at a very low dose (a few drops are enough), to treat the inflammatory component of the malar bag.
• An injection of hyaluronidase, after an allergy test. This is the same product used to dissolve hyaluronic acid injected in excess, most often into the dark circles. The technique gives very significant results in reducing malar oedema, through a process that is still difficult to explain.

And techniques to fill the sub-malar hollow located in the tear trough, which involve injecting hyaluronic acid deep down at bone contact to restore the malar volume lost through fat melting.

Combining these medical techniques gives excellent results and often makes it possible to postpone surgical treatment of the malar bag.

In pronounced forms, surgery is the only way to improve malar bags significantly.
It combines a submuscular lift with malar lipostructure.
The submuscular lift is a genuine re-tensioning of the orbicularis muscle, which festoons the eyelid. The muscle is re-anchored to the bone so that this muscular excess can be tightened optimally.
This eyelid muscle mini-lift is combined with malar lipostructure to fill the sub-malar hollow that often contributes to the malar bag.

Injection techniques for treating malar bags are very useful, as they make it possible to postpone malar bag surgery, a relatively demanding procedure that requires extensive muscle detachment in order to lift the muscle, as well as lipostructure over the cheekbone.

As soon as significant signs of malar bags appear, contact Dr Hayot, ophthalmologist and oculoplastic surgeon.

Frequently asked questions about malar bags

What causes malar bags to appear?

The cause of malar bags is very difficult to pinpoint, as it is multifactorial. It is in fact a form of oedema of the orbicularis muscle overlying the malar bone. This oedema may be of lymphatic origin, or due to slight ptosis of the orbicularis muscle. The causes remain poorly understood, so it is very difficult to say what makes malar bags appear, since the problem is lymphatic.

Triggering factors have been identified, such as botulinum toxin injections into the lower orbicularis muscle and the lower crow’s feet. Malar bags are also often familial and hereditary in origin, and may be inflammatory.

What are the treatment prices?

As the causes can differ from one patient to another, treatment is tailored to each case. It is therefore difficult to give an overall price for an aesthetic treatment. I will provide you with a detailed, personalised estimate after our initial consultation.

Does medical treatment of malar bags simply postpone surgery? Is there a point at which I can tell myself that only surgery will correct this problem?

Medical treatment does not merely postpone surgery. When the malar bag is of inflammatory origin, there are a few cases in which a cortisone injection over the malar bone makes it disappear completely. Hyaluronic acid injections, too, occasionally make the malar bag disappear completely.

What you need to know, however, is that there is virtually no definitive treatment for malar bags, because although surgery treats their consequences by lifting the muscle, it does not treat the cause, which remains poorly understood.