Festoons are a specific type of under-eye swelling or puffiness, often mistaken for typical under-eye bags. They represent a distinct condition with unique characteristics and causes. Understanding these factors helps clarify why they appear and how they differ from other forms of puffiness. This article will explain what festoons are and explore the various factors that lead to their development.
Understanding Festoons
Festoons, also known as malar mounds or malar bags, manifest as swollen, crescent-shaped areas of skin and tissue. They typically appear on the cheekbone below the lower eyelid, extending onto the upper cheek, and can give the face a tired or aged appearance. These mounds can be “wet,” indicating fluid accumulation, or “dry,” referring to overhanging skin alone. Unlike common under-eye bags, which are often caused by the protrusion of orbital fat or simple fluid retention directly beneath the lash line, festoons are located lower on the face, at the junction of the lower eyelid and cheek.
The distinction lies in their anatomical origin and composition. Typical under-eye bags result from the weakening of the orbital septum, allowing fat pads around the eye to bulge forward. Festoons, however, involve laxity of the orbicularis oculi muscle, a muscle that helps close the eyelids, and the skin in the malar (cheek) area. This loosening of muscle and surrounding tissues allows for sagging and swelling, often exacerbated by fluid retention. When touched, festoons tend to feel squishy and can be moved side to side, whereas typical under-eye bags are firmer and less mobile.
Factors Contributing to Festoon Formation
Several factors contribute to festoon development, ranging from natural aging to environmental and lifestyle influences. These elements often interact, leading to their complex presentation.
Aging
Aging plays a role in festoon formation as the skin naturally loses its elasticity and firmness over time. The collagen and elastin fibers in the skin, which provide structural support, diminish with age, leading to skin laxity. This weakening of supporting structures, including the orbicularis oculi muscle and ligaments that hold facial tissues in place, allows for the sagging and fluid accumulation characteristic of festoons.
Sun Exposure
Sun exposure is another contributor to festoon development, as ultraviolet (UV) radiation damages the skin’s collagen and elastin fibers. This breakdown of proteins accelerates skin laxity and can impair the lymphatic drainage system, further promoting fluid accumulation in the lower eyelid and cheek regions. Years of unprotected sun exposure can cause structural problems in the skin, making the delicate tissues more prone to sagging and swelling.
Genetic Predisposition
Genetic predisposition also influences whether an individual develops festoons. Some people are genetically more susceptible to this condition, with a family history of festoons increasing their likelihood. This suggests that inherited traits can affect the strength and resilience of the skin and underlying facial structures.
Lifestyle Factors
Lifestyle factors can influence the appearance of festoons. Chronic fluid retention, often influenced by high salt intake or excessive alcohol consumption, can worsen puffiness in the malar area. Smoking also accelerates skin aging by damaging collagen and elastin, contributing to skin laxity. Lack of sleep can intensify general puffiness around the eyes, making existing festoons more noticeable.
Medical Conditions and Medications
Certain medical conditions and medications can be associated with fluid retention that contributes to festoon formation. Conditions such as allergies, chronic sinusitis, thyroid issues, kidney problems, or heart conditions can lead to generalized swelling or fluid buildup in the body, including the face. For example, hypothyroidism can contribute to periorbital aging changes, including edema and festoons. While these conditions may not directly cause the structural changes of festoons, the fluid retention they induce can worsen their appearance.