Solutions for the treatment of malar pockets:

From a therapeutic point of view, there are two attitudes, depending on whether the malar pocket is in its early stages and moderate or very pronounced. In moderate forms, medical treatment (injections) is usually sufficient.

My technique consists of combining techniques to deflate the pocket:

• Delayed cortisone injection, opposite the bone contact, at a very low dose (a few drops are enough) to treat the inflammatory involvement of the malar pocket.
• Injection of hyaluronidase (after an allergy test), the same product that dissolves hyaluronic acid injected in excess, most often into the eye circles, this technique gives very significant results in reducing malar edema by a process that is still difficult to explain.

And techniques to fill the sub-malar hollow located in the valley of tears, which involve injecting hyaluronic acid deep into the bone contact to restore malar volume that has been diminished by fat loss.

The combination of these two medical techniques gives excellent results, and often makes it possible to defer surgical treatment of the malar pocket.

In pronounced forms, surgical treatment is the only way to significantly improve malar pockets.
This involves a combination of submuscular lifting and malar lipostructure.
The submuscular facelift is a genuine re-tensioning of the orbicularis muscle, which festoons the eyelid. This muscle will be re-marmed to the bone to enable optimal re-tensioning of this muscular excess.
This eyelid muscle mini-facelift will be combined with a malar lipostructure to fill the sub-malar hollow that often contributes to the malar pocket.

Injection techniques for the treatment of malar pouches are very interesting, as they allow us to postpone malar pouch surgery, a relatively cumbersome procedure that requires extensive muscle detachment in order to lift the muscle, as well as lipostructure on the cheekbone.

So as soon as significant signs of malar bags appear, contact Dr Hayot, a specialist in aesthetic medicine.

Frequently asked questions about malar pouches

What causes malar pockets to appear?

The cause of malar pockets is very difficult to pinpoint, as the causes are multifactorial. In fact, it’s a kind of edema in the orbicularis muscle opposite the malar bone. This edema may be of lymphatic origin, or due to a small ptosis of the orbicularis muscle. The causes are not very well known, so it’s very difficult to know what causes the appearance of malar pockets, since it’s a lymphatic problem.

Triggering factors have been identified, such as botox injections in the lower orbicularis muscle and the lower crow’s feet. The malar pouch is also often familial and hereditary in origin, or may also be inflammatory.

What are the treatment prices?

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

Will medical treatment of malar pockets just postpone surgery for a while? Is there a point where I can say to myself that only surgery will correct this pocket problem?

Medical treatment doesn’t just postpone surgery. In some cases, between 10% and 20%, medical treatment can be definitive. When the malar pocket is of inflammatory origin, there are a few cases where cortisone injection opposite the malar bone can make the malar pocket disappear completely. On the other hand, hyaluronic acid injections occasionally make the malar pocket disappear completely.

What you need to know, however, is that there is virtually no definitive treatment for malar pouch, because although surgery treats the consequences of malar pouch by pulling up the muscle, it does not treat the cause, which is in fact not very well known.