We are open - The Cadogan Clinic is currently open for all appointments. LEARN MORE
0207 901 8500 We Are Open
Get in touch

Festoons (Malar Pads)

The festoon is the bulge of skin and tissue of the cheek below the edge of the orbital rim and is therefore below the lower eyelid. It is made up of lax skin and thinned out muscle as a cascading drape. It and the underlying fibrous tissue is swollen with tissue fluid. It first shows as swelling, becoming a mound (malar pads) and then a full-blown festoon.

There is a hereditary predisposition, but it becomes more obvious with age and the destruction of skin elasticity by the sun. Anything which increases oedema makes the appearance worse, and this could be anything from metabolic disease to a heavy night out. It will always be worse in the morning after lying flat. Later in the day, the excess fluid will redistribute itself around the body, perhaps ending up as swollen ankles!

A particular issue is extra swelling of the malar pads or festoons following injury or surgery of the eyelids or above. Any surgical attempt to correct the problem will cause increased swelling initially, which takes some months to settle. Be warned!

Malar pads and festoons often come associated with eye bags and surplus skin of both the upper and lower eyelids (dermatochalasis). Surgery to these causes prolonged worsening of the malar pads (festoons) below. Happily, it does eventually settle.

Treatment is difficult and elected therapy is based on the severity of the condition. Tightening skin by fractional laser, ultherapy, radiofrequency or chemical peel is effective in the earlier stages and as an adjunct to surgery. Mid facelift is a radical treatment. When all else fails then direct excision works well but will leave a scar. This is not a problem for those who always wear make-up.

In some cases, crepy wrinkles overlying festoons in the skin are removed using lasers.

Related Treatments:


Of course, we use the very latest technology. But our real skill is in knowing how and when to use it to suit each individual patient.


Ask the Expert


Daily Mail talks Chlorophyll with Dr Mayou

With over 220 million videos posted on TikTok with the hashtag #chlorophyll and a cult following of celebrities who are praising the ingredient.

Read More

How to treat eczema

Body & Breast

How to treat eczema

Atopic eczema is a very common skin disorder that affects around 1 in 9 people in the UK at some point in their lives. Those who experience eczema are…

Is eczema contagious?

Body & Breast

Is eczema contagious?

Those who suffer from the condition, as well as those around them, may have concerns and wonder is eczema contagious. Eczema is an extremely common skin…

What is adult acne?

Facial Treatments

What is adult acne?

Acne is a common skin condition that is usually associated with teenagers. In this age group, acne is often caused by a change in hormone levels and in…

In The Press This Week

This month Consultant Dermatologist Dr Susan Mayou discusses rosacea with, and talks to the Daily Mail about the latest skincare craze, chlorophyll.

View All News Articles