Malar mounds and festoons: review of current management

Aesthet Surg J. 2014 Feb;34(2):235-48. doi: 10.1177/1090820X13517897. Epub 2014 Jan 15.


Blepharoplasty, the most common aesthetic eyelid procedure, sometimes involves a challenging patient subgroup: those who present with malar edema, malar bags, and festoons. In this review article, the authors describe the relevant anatomy in festoon development, discuss the pathophysiological basis of this condition spectrum, outline clinical examination basics, summarize various surgical approaches for treatment and propose an algorithm for their application, and describe the most common postsurgical complications.

Keywords: blepharoplasty; facelift; festoons; malar edema; malar mounds; oculoplastics; periorbital rejuvenation.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / anatomy & histology
  • Algorithms
  • Blepharoplasty / methods*
  • Cheek / surgery*
  • Edema / surgery
  • Eyelids / anatomy & histology
  • Facial Muscles / anatomy & histology
  • Humans
  • Lipectomy
  • Medical History Taking
  • Patient Selection
  • Physical Examination
  • Rhytidoplasty / methods*
  • Skin Aging*
  • Subcutaneous Fat / anatomy & histology
  • Surgical Flaps