Malar bags: clinical features and therapeutic options

Malar bags are a common aesthetic concern characterized by swelling and puffiness in the prezygomatic space and cheek area. Various medical and surgical techniques have been developed to address this condition and restore a more youthful and rejuvenated appearance. In terms of medical therapies, non-invasive options such as topical creams containing retinoids, peptides, and hyaluronic acid have shown promise in reducing mild malar bags. These substances help improve skin texture, promote collagen production, and enhance skin elasticity, thereby reducing the appearance of swelling and puffiness. Additionally, injectable treatments such as dermal fillers have been utilized to camouflage malar bags and create a smoother contour. By strategically placing fillers in the surrounding areas, a skilled practitioner can achieve a more harmonious facial appearance. In recent years, advancements in radiofrequency have also shown promise for treating malar bags. Laser skin resurfacing procedures can help tighten the skin, stimulate collagen production, and reduce the appearance of swelling and wrinkles in the malar area. For patients seeking more lasting results, surgical techniques provide viable options. Blepharoplasty, a surgical procedure aimed at correcting eyelid issues, can be performed to remove excess skin and fat deposits in the lower eyelid, effectively addressing malar bags. Additionally, newer techniques like endoscopic surgery allow for minimal incisions and reduced scarring, making them appealing to patients concerned about visible postoperative marks. Although numerous medical and surgical techniques are available, the choice of treatment depends on factors such as the severity of the condition, patient preferences, and the expertise of the medical practitioner. In this manuscript we have made a retrospective evaluation of the medical and surgical therapies of malar bags and we report our considerations after 20 years of experience.