Under-Eye Bags, Festoons, and Malar Edema: What Is the Difference?
These conditions look similar but have different anatomy — and different treatments.
Critical point: Lower eyelid blepharoplasty effectively treats orbital fat prolapse (bags), but does not treat festoons — and in some cases may make them more visible by altering the surrounding tissue tension. Correct diagnosis before any procedure is essential.
| Condition | Location | Fluctuates? | Treatment |
|---|---|---|---|
| Orbital fat bags | Just below the lower lash line | Slightly (worse mornings, salt, fatigue) | Lower blepharoplasty ✓ |
| Festoons | Lower eyelid/upper cheek junction | Significantly — varies day to day | Direct excision or laser — not bleph |
| Malar edema | Cheekbone (malar) area | Greatly — may be absent some days | Treat underlying cause first |
| Tear trough hollow | Depression below lower lid | No | Hyaluronic acid filler |