Malar Bags vs Festoons

Linda Robison, Facial Fitness Specialist.

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Linda Robison, Facial Fitness Specialist.

Disclosure: As an Amazon Associate, I earn from qualifying purchases and may earn from other affiliate links.

We'll explain the difference between festoons and malar bags, along with what causes them and the treatments that may help improve their appearance.

Malar bags vs festoons: What is the difference between the two?

Malar bags sit higher on the cheekbone and usually look firmer or puffier. Festoons tend to sit lower on the upper cheek and often appear looser or more draped. Both can look similar to under-eye bags, but they involve different areas of the face.

While they may appear similar and are often confused with lower eye bags, it's important to note that malar bags and festoons are distinct conditions.

One thing is certain: both can be quite bothersome, potentially giving you an older or tired appearance.

In this article, you'll learn:

• the difference between malar bags and festoons
• what causes them
• prevention tips that may help
• treatment options ranging from natural approaches to medical procedures

They may look similar at first, but the biggest differences involve where they appear on the face, how they look, and what causes them.

Malar bags. Also known as cheek bags, are pouch-like swellings that are specifically located near the lower eyelid and above the cheekbone. They are situated higher on the face compared to festoons.

Festoons. Typically, sit lower on the face compared to malar bags. These pouch-like swellings are commonly located in the cheek area, and can extend into the mid-cheek region. 

Let's break down the difference between festoons and malar bags.

Quick comparison: malar bags vs festoons

Although they look similar, malar bags and festoons differ in their location, texture, and underlying causes.

Malar bags

• Sit higher on the face, just below the lower eyelid
• Usually appear as a small pouch over the cheekbone
• Often look firmer and more defined
• Commonly linked to fluid buildup and changes in the cheek fat pads

Festoons

• Sit lower on the upper cheek area
• Often appear as larger, draped or hammock-like skin folds
• Usually softer and more wrinkled in texture
• Often involve fluid retention and loose skin in the cheek area

Malar bags festoons can develop for several different reasons.

Quick tip:  If your “puffy eyes” sit lower on the cheekbone instead of directly under the lower lash line, you may be dealing with malar bags or festoons—not regular under-eye puffiness. Cold compresses, sleep, salt reduction, and gentle massage may help temporary swelling, but they usually won’t fully fix true malar bags or festoons.

What causes malar bags

Malar bags are puffy swellings that develop just below the lower eyelid and above the cheekbone. They usually develop from a combination of fluid buildup, weakening of the skin and supporting tissues in the cheek area, and changes in the fat pads that sit under the eyes.

Swelling (edema), skin laxity, and changes in the cheek fat pads can all contribute to this bag-like appearance. Aging, sun exposure, and genetics may also play a role.

Location: Malar bags appear near the tear trough of the lower eyelid and just above the cheekbone.

Appearance: They are usually smaller and more localized than festoons and often create a bulging look over the cheekbone area.

Texture: Malar bags tend to appear firmer in texture compared to festoons.

What causes festoons under eyes?

Festoons share some of the same underlying causes as malar bags, but they usually involve more noticeable skin laxity and fluid buildup in the upper cheek area.

As the skin and supporting tissues weaken, the area below the eyes can begin to sag and form larger folds or pouches.

Location: Festoons typically appear in the lower eyelid–upper cheek area and may extend farther into the mid-cheek region.

Appearance: They often look larger and more draped than malar bags, sometimes forming hammock-like folds of skin filled with fluid or fat.

Texture: Festoons usually appear softer and more wrinkled compared to the firmer look of malar bags.

Both festoons and malar bags can make the face look tired or aged. Treatments are not always straightforward, and results can vary depending on the underlying cause and severity.

Below we'll look at some preventative measures and treatment options ranging from natural approaches to medical procedures.

Preventing malar bags and festoons

If genetics aren’t the main cause, there are a few simple steps that may help reduce the risk of these issues developing over time.

1. Sunscreen:

We all know this, but it matters. Sun damage breaks down collagen and weakens the skin over time. Studies show that daily sunscreen use can help protect — and even improve — visible signs of aging.

2. Skin tightening heating treatments:

Procedures like Thermage and Ultherapy can tighten the skin, but they may also come with a downside: potential facial fat loss. This is why it’s so important to work with an experienced practitioner.

3. Diet and fluid retention:

Diet alone will not remove malar bags or festoons, but certain eating habits can make swelling more noticeable. High sugar diets can weaken collagen over time through glycation, and high-salt or heavily processed foods may increase fluid retention around the eyes and cheeks.

Supporting your skin with nutrient-rich foods may help maintain better skin quality as you age. See: skin nourishing foods for healthy skin.

Malar bags vs festoons: Treatments

The right treatment for malar bags or festoons depends on how severe they are and what’s causing them.

These puffy areas usually come from a mix of fat pad changes, fluid buildup, and weakening of the skin and supporting tissues in the cheek area. Because of that, some treatments can help improve how they look—while others are better suited for more advanced cases.

Face massage

Gentle massage can help improve circulation and move fluid through the area. This may reduce some of the puffiness that collects in the upper cheek.

If you want a simple place to start, try the Circle Up Rub technique.

Facial exercises

Certain facial exercises may help strengthen the muscles that support the cheeks. Stronger cheek muscles can improve facial contours and give a bit more support to the area under the eyes.

They’re also one of the easiest ways to help your face look firmer over time. You can see an example in this 3-step cheek builder video.

Under-eye tightening serums

If you're looking for something that works more quickly, under-eye tightening serums can help smooth and firm the area temporarily.

To be clear, these serums don’t treat malar bags or festoons directly, but they may help reduce the appearance of puffiness and make the skin look tighter for a few hours.

If you're considering products for puffiness, I tested several options in my under-eye puffiness serum review, including which ones gave the most noticeable tightening effect.

Topical treatments

Some skincare ingredients can help improve the look and feel of the skin around the eyes and cheeks. Retinoids, peptides, and antioxidants all support collagen and overall skin quality.

They won’t remove malar bags or festoons, but they can help the surrounding skin look smoother and more refreshed.

Botox

Botox doesn’t remove malar bags or festoons. These are usually caused by fat pads, fluid, and skin changes—not muscle movement.

That said, Botox may soften lines around the eyes and slightly reduce downward pull, which can improve the overall look in some cases. You can also explore whether Botox helps with eye bags, depending on the cause.

Dermal fillers

Fillers are sometimes used to smooth the transition between the cheek and under-eye area. This can reduce shadows and make everything look more even. You can learn more about filler for under-eye puffiness here.

They need to be used carefully, though, since some fillers attract water and can make swelling worse. An experienced injector will choose the right approach based on your situation.

PRP or PRF injections

PRP and PRF use components from your own blood to support healing and collagen production.

Some providers use these treatments around the eye and cheek area to improve skin quality and reduce puffiness. Results are usually subtle, but some people do notice improvement.

Laser or radiofrequency treatments

These treatments use controlled heat to tighten the skin and improve texture. They may help mildly with festoons or loose skin, but they usually don’t fully remove the bags.

Antibiotic injections

Some specialists use injections like tetracycline to help shrink festoons.

These injections aren’t used to treat infection. Instead, they create a controlled tightening effect in the tissue, which may help reduce fluid pockets in the area.

This is a more specialized treatment and isn’t widely offered. Results can vary, and this type of treatment is typically performed by experienced specialists.

Surgery

For more advanced cases, procedures like lower eyelid surgery or a mid-face lift may be recommended.

These can reposition tissue and remove excess skin or fat, which can significantly improve the appearance of malar bags or festoons.

FAQ: Malar bags vs festoons

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About the Author:

Linda Robison is an anti-aging advisor for women over 40, sharing natural methods, facial exercises, and beauty routines she's personally tested over the years for smoother, firmer-looking skin. She spent nearly 15 years as an Anti-Aging Health Advisor at the Life Extension Foundation and has been testing facial anti-aging techniques for over 30 years, including training in Carolyn’s Facial Fitness. Her tips have been featured in GB News and Beauty Box Magazine. You can also view her background on LinkedIn. For more everyday tips follow along on Pinterest.

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