Malar Bags vs Festoons

Linda Robison, Facial Fitness Specialist.

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

Not all “puffy eyes” are the same.

Sometimes swelling sits directly under the lower lashes. Other times, the puffiness drops lower and shows up as a mound over the cheekbone. That’s where malar bags and festoons can get confusing.

Malar bags usually sit higher on the cheekbone and may look firmer or puffier. Festoons tend to sit lower on the upper cheek and often look softer, looser, or more draped.

Both can make the eye area look tired, even when you feel fine. And while they can look similar to regular under-eye bags, they don’t always respond to the same fixes.

In this article, you’ll learn:

• the difference between malar bags, festoons, and regular under-eye puffiness
• what may cause cheekbone bags or swelling
• what at-home steps may help temporary puffiness
• which treatments may be worth discussing with a qualified provider

They may look similar at first, especially if you’re just thinking, “Why do my eyes look puffy?”

But the biggest clue is location.

Regular under-eye puffiness usually sits directly below the lower lash line. Malar bags usually show up a little lower, over the cheekbone. Festoons tend to sit even lower on the upper cheek and may look more like a soft fold or drape.

So before you think about treatments, it helps to figure out where the swelling actually sits.

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

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

Quick tip:  If the puffiness changes from day to day, looks worse in the morning, or improves with sleep, hydration, or less salt, it may be more fluid-related.

But if the mound stays in the same place over the cheekbone, it may be more structural. That’s when regular “puffy eye” tricks may only help a little.

What causes malar bags

Malar bags usually form from a mix of fluid buildup, skin laxity, and changes in the cheek fat pads.

As the skin and support tissues under the eyes weaken, fluid can collect in the area above the cheekbone. This can create a puffy, raised mound that looks different from regular under-eye bags.

Aging, sun damage, genetics, allergies, and fluid retention may all play a role. That’s why malar bags can look worse some days, especially if swelling is part of the problem.

Location: Malar bags usually appear just below the lower eyelid and above the cheekbone.

Appearance: They often look like a small raised pouch or mound over the cheekbone.

Texture: Malar bags may look firmer and more defined than festoons.

What causes festoons under eyes?

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

As the skin and support tissues under the eyes become weaker, the area can start to sag. This may create a larger fold or pouch that sits lower than a typical under-eye bag.

Festoons may be influenced by aging, sun damage, genetics, chronic swelling, allergies, and skin laxity.

Location: Festoons usually appear where the lower eyelid meets the upper cheek and may extend into the mid-cheek area.

Appearance: They often look larger and more draped than malar bags, almost like a soft fold or hammock.

Texture: Festoons usually look softer, looser, or more wrinkled than malar bags.

Note: Before we get into prevention and treatments, it helps to remember this: malar bags and festoons are not always caused by the same thing.

Sometimes puffiness is mostly fluid. Sometimes it’s loose skin, fat pad changes, or facial structure. That’s why regular “puffy eye” tricks may help a little, but they may not fully smooth the area.

Preventing malar bags and festoons

You may not be able to fully prevent malar bags or festoons, especially if genetics, facial structure, or aging changes are involved.

But you may be able to reduce the things that make puffiness look worse.

1. Protect the skin from sun damage

Sun damage weakens collagen and makes the thin skin around the eyes and cheeks less firm over time. Daily sunscreen is one of the simplest ways to protect this area and support better-looking skin as you age.

2. Watch swelling triggers

Salt, alcohol, poor sleep, allergies, and dehydration can all make the under-eye and cheek area look puffier. These things may not cause true malar bags or festoons, but they can make them more noticeable.

3. Support skin quality from the inside

Diet alone will not remove malar bags or festoons. But nutrient-rich foods may help support collagen, skin repair, and a healthier-looking complexion over time.

See: skin nourishing foods for healthy skin.

Bottom line: Prevention is mostly about protecting the skin and reducing extra swelling. It may help the area look better, but it usually won’t erase true malar bags or festoons.

Malar bags vs festoons: Treatments

The right treatment depends on what is causing the puffiness.

That’s the tricky part. Malar bags and festoons can involve fluid buildup, loose skin, fat pad changes, or facial structure. So the best place to start is with the least risky options first.

A simple way to think about it:

Try to reduce temporary swelling first.
Support the skin around the eyes and cheeks next.
Then consider a qualified medical provider if the mound is fixed, getting worse, or not responding to basic care.

Below are the main options, from at-home support to professional treatments.

Face massage

Gentle face massage may help if some of the puffiness is fluid-related. It can encourage movement in the area and may make the upper cheek look a little less puffy temporarily.

But massage will not remove true malar bags or festoons if they are caused by loose skin, fat pad changes, or facial structure.

That said, it’s still one of the easiest, lowest-risk places to start — especially if your puffiness comes and goes.

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

Facial exercises

Facial exercises won’t remove true malar bags or festoons, but they may help support the cheek area over time.

When the cheek muscles are stronger, the mid-face can look a little more lifted and supported. That may help the area under the eyes look better overall, especially if facial sagging is part of the issue.

This is not a quick fix for cheekbone bags, but it can be a helpful part of a firmer-looking face routine.

You can see an example in this 3-step cheek builder video.

Under-eye tightening serums

Under-eye tightening serums can be helpful when you want the area to look smoother for a few hours.

But this is important: these products do not treat true malar bags or festoons. They work more like a temporary cosmetic tightener, especially when puffiness or crepey texture is making the area look worse.

So they may help the skin look tighter and less puffy for a short time, but they won’t remove a fixed mound over the cheekbone.

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

Skincare can help the skin around the eyes and cheeks look smoother, firmer, and more refreshed.

Ingredients like retinoids, peptides, antioxidants, and gentle moisturizers may support better skin quality over time. This can be helpful if the area looks crepey, thin, dull, or tired.

But topical products will not remove true malar bags or festoons. Think of them as skin support — not a structural fix.

Bottom line: Skincare may improve the look of the surrounding skin, but it won’t erase a fixed cheekbone mound.

Botox

Botox does not remove malar bags or festoons because these puffy areas are usually not caused by muscle movement.

But in some cases, Botox may help soften crow’s feet or reduce tiny lines around the eyes. That can make the eye area look a little smoother overall, even if the cheekbone mound is still there.

So I’d think of Botox as an eye-area softener, not a true malar bag or festoon treatment.

You can also explore whether Botox helps with eye bags, depending on the cause.

Dermal fillers

Dermal fillers may help in some cases if the main issue is shadowing or a hollow transition between the under-eye area and cheek.

But fillers do not actually remove malar bags or festoons. And this is where you want to be careful: some fillers attract water, which may make swelling look worse in people who already have puffiness in this area.

So fillers are not something I’d casually try for cheekbone bags. They’re best discussed with an experienced injector who understands the under-eye and mid-face area.

You can learn more about filler for under-eye puffiness here.

PRP or PRF injections

PRP and PRF use components from your own blood to support healing, collagen, and skin quality.

Some providers use these treatments around the under-eye and cheek area when the skin looks thin, crepey, or tired. The results are usually subtle, not dramatic.

PRP or PRF may help the skin look healthier, but they should not be viewed as a guaranteed fix for true malar bags or festoons.

This is one of those options to discuss with a qualified provider, especially if you’re trying to improve skin quality without adding filler.

Laser or radiofrequency treatments

Laser and radiofrequency treatments use controlled heat to firm the skin and improve texture.

They may help if loose skin or crepey texture is making the area look worse. But they usually do not fully remove true malar bags or festoons, especially when fluid pockets, fat pad changes, or facial structure are involved.

This is also where experience matters. The skin around the eyes and upper cheeks is delicate, so it’s worth working with someone who treats this area often.

Bottom line: These treatments may improve skin quality and mild laxity, but they are not always a complete fix for cheekbone bags.

Specialist treatments

For more noticeable malar bags or festoons, some people may need a specialist evaluation.

Certain providers use treatments such as tetracycline injections for festoons. These are not used to treat an infection. They are used in a controlled way to help tighten tissue and reduce fluid pockets in selected cases.

For more advanced cases, surgical options such as lower eyelid surgery or a mid-face lift may be discussed. These procedures may help reposition tissue, tighten loose skin, or improve the cheek and lower-eye transition.

But this is not one-size-fits-all. The right option depends on whether the problem is fluid, loose skin, fat pad changes, or facial structure.

Important: If swelling is sudden, painful, one-sided, red, or getting worse quickly, don’t treat it like normal puffy eyes. It’s best to check with a qualified medical provider.

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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