Festoons are a common aesthetic concern characterized by puffiness or swelling on the upper cheeks, often extending from below the lower eyelids. These crescent-shaped folds can create a tired or aged appearance. While sometimes confused with typical under-eye bags, festoons are a distinct condition. Understanding their nature and potential variability is important for individuals seeking clarity on this facial characteristic.
Understanding Festoons
Festoons are crescent-shaped folds or mounds of skin and tissue that develop on the upper cheek, along the cheekbone, beneath the lower eyelid. They are also referred to as malar mounds or malar bags. Unlike traditional under-eye bags, which are primarily caused by fat protruding from the eye socket, festoons involve fluid and weakened tissue in the cheek area. Festoons are typically located around the bony orbital rim at the lower lid-cheek junction.
The Dynamic Nature of Festoons
Festoons can fluctuate in prominence, becoming more or less noticeable at different times due to various temporary factors. Fluid retention is a significant contributor to their variability, often worsening their appearance. Conditions such as allergies, chronic sinusitis, or inflammation can lead to increased fluid accumulation, making festoons more pronounced. Lack of sufficient sleep and high sodium intake can also exacerbate the puffiness. Medications, including steroids, acetaminophen, and nonsteroidal anti-inflammatory drugs, are known to cause fluid retention that impacts festoon visibility, and festoons might be more noticeable in the morning due to fluid pooling overnight.
Underlying Factors and Long-Term Changes
Underlying and chronic factors contribute to the formation and persistent presence of festoons. A primary cause is the weakening of collagen and elastin, proteins that provide skin elasticity and firmness. This weakening results from the natural aging process. Sun damage from UV ray exposure significantly accelerates this breakdown of collagen and elastin. Genetic predisposition also plays a role.
Issues with lymphatic drainage, which removes excess fluid from tissues, can lead to chronic fluid accumulation in the cheek area. Smoking is another factor that weakens skin structure. Additionally, medical conditions like thyroid disease or rosacea can cause inflammation and swelling. Improper placement of dermal fillers can also exacerbate festoons due to fluid attraction or the weight of the filler itself.
Strategies for Management
Managing festoons involves conservative approaches and professional treatment options. Addressing allergies or chronic inflammation can help reduce fluid retention. Improving sleep habits, reducing dietary sodium intake, and ensuring adequate hydration may also lessen temporary puffiness. Sun protection helps prevent further damage to skin elasticity. Gentle facial massage can stimulate lymphatic drainage.
Professional treatments include non-surgical and surgical interventions. Non-surgical options include various laser therapies and radiofrequency treatments, which aim to tighten skin and stimulate collagen production. Surgical procedures like direct excision or techniques that redrape soft tissues and tighten weakened muscles may be considered. Lower blepharoplasty and mid-facelift procedures are often used in combination to address festoons and restore facial contours. Consulting with a dermatologist or plastic surgeon is advisable to determine the most suitable treatment plan.