The malar pouch is a disorder that I frequently see as an oculoplastic surgeon (specialist in eyelid surgery).
Malar pouches are located in the upper part of the cheekbone and frequently cause the formation of a “double under-eye circle”.
An inflammatory oedema combined with a muscular swag around the eye form a malar pouch. If, at the same time, tear trough widens, the effect of the malar pouch located just above is heightened.
Solutions for treating malar pouches:
Seen from a therapeutic viewpoint, two attitudes exist depending on whether the malar pouch is debuting, moderate or highly-pronounced. In the moderate forms, a medical treatment (injections) is often enough.
My technique consists in combining techniques to deflate the pouch:
- Injection of cortisone retard, at bone-contact level, at a very low dosage, (a few drops are enough) to treat the inflammatory participation of the malar pouch.
- Injection of hyaluronidase (following an allergy test), this is the same product that is used to dissolve the hyaluronic acid that has been over-injected into the under-eye circle; this technique provides highly-significant results in reducing the malar oedema through a process that is still difficult to explain.
And techniques to fill the sub-malar space located in the tear trough, which consists in deeply injecting hyaluronic acid at bone-contact level to restore malar volume which was reduced by the loss of fat.
The combination of these two medical techniques returns excellent results and very frequently leads to malar pouch treatment being postponed.
In the pronounced forms only surgical treatment can be used to clearly improve the malar pouches.
This consists in a combination of sub-muscular lifting and malar lipostructure.
Sub-muscular lifting comprises real tightening of the orbicularis muscle which swags; this muscle will be re-fastened to the bone so that the muscular excess can be optimally tightened.
The mini muscular lifting of the eyelid will be combined with a malar Lipostructure which will permit the sub-malar space, which is very frequently part of the malar pouch, to be filled.
The malar pouch treatment techniques by injection are highly-interesting as they allow malar pouch surgery to be postponed; surgery is relatively a major one, where it is necessary to largely detach the muscle, then put it back and also to perform lipostructure on the cheekbone.
Therefore, as soon as there are significant signs of malar pouches, contact Dr Hayot, specialist in aesthetic medicine.