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Malar mounds/bags

Malar mounds/bags

Postby shirl1 » Thu Feb 08, 2007 11:06 pm

Hi girls, I have malar mounds, they are not bags, just an area that looks like a fat pad high on the cheekbone with a demarcation line between it and rest of cheek. I have seen lots of stuff on the net about these but no real answer. Any of you ladies got any ideas :?:

Shirley
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Postby Refreshme » Fri Feb 09, 2007 4:03 am

Shirl, I think I have one also. Right next to my mouth cheek area when I smile you can see a small lump almost looks like a gauze pad was left behind. I wonder if massaging helps?? Other side is smooth.
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Postby shirl1 » Fri Feb 09, 2007 5:00 am

Hi Refreshme, that sounds like something different, mine are high on the cheekbone under my eyes.
Why us thats what i want to know? Have you heard how WD is doing?
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Postby Refreshme » Fri Feb 09, 2007 9:50 am

shirl1 wrote:Hi Refreshme, that sounds like something different, mine are high on the cheekbone under my eyes.
Why us thats what i want to know? Have you heard how WD is doing?
Shirley


I haven't heard a word, hope she is alright!!!!
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Re: Malar mounds/bags

Postby MissJ521@aol.com » Fri Feb 09, 2007 10:41 am

Hi Shirl,

"Some Ideas":

If the lower border of the Malar mounds is in the same area as say the 'black eye' area; where IF you got a black eye, the bruising would STOP and not travel further down the face, that's usually indicative of a ligament being there; a part of the internal anatomy of face (a fascia like thing), that SEQUESTERS "stuff" so that the "stuff" does not travel downward past where the border of the ligament is.

Such an anatomical part has been identified by a Joel Pessa MD and called the "malar septum". Here is a link that will tell you a little about it: http://www.uthscsa.edu/mission/spring98/malar.html

Things like malar bags or "festoons" also seem to be located in that area.

Treatment of these things seems to elude PSs. For example a few years back there was a "round table" of PSs published in the ASAPS journal in which some pretty 'big name' docs were asked how they would treat a patient with them. The answers differed from doc to doc and no one really had much of a definitive one.

As a very 'inquisitive' patient myself who is always thinking in terms of: 'What "would" or what "could" work or what "makes sense to ME" even IF the docs as a whole body have not recognized "officially" what I think could or would work, I have long had the "hunch" that volume augmentation to the superficial fatty layer of the face in the vicinity of this 'sequestered mound thing' would BLEND IT IN .

Since that, I have been 'following' the outcomes of a few patients to whom I had suggested to seek out Derms conversant in soft tissue volume augmentation, in the superficial fatty layer, (with a variety of fillers) and to ASK the doc IF he would fill in the vicinity of this mound as to BLEND it in with the rest of cheek complex so the "step off" is not that visually apparent. Doing just that did blend the thing in more. The 'trade-off' is that the person having it needs to accept a FULLER over all cheek area, which is not too much of a trade off considering full cheeks are aesthetically desirable.

If I were "in your johnny" with your situation, I would seek out consults with Derms with a LOT of experience injecting an assortment of soft tissue fillers to the fatty layer under the skin with the specific question of CAN they "visually" BLEND THIS in for you so that the demarcation is not that apparent and so you can have full yet CONTINUOUS 'curve' to the cheeks.

Here is a LINK and to a UK site discussing dermal fillers: http://www.consultingroom.com/Treatment ... %20Fillers

One of the fillers on that list which is:
A: permanent
B: is used in UK
C: injected as a soft tissue implant that can be 'shaped'

is Bio-Alcamid

Although the decision as to which filler to use should be a mutual decision between YOU and YOUR DOCTOR, the option of whether or not this filler would or could be used for your situation, could be discussed if you included a consult (or even a few) with a doc who used this filler (in addition to a variety of other fillers.)




shirl1 wrote:Hi girls, I have malar mounds, they are not bags, just an area that looks like a fat pad high on the cheekbone with a demarcation line between it and rest of cheek. I have seen lots of stuff on the net about these but no real answer. Any of you ladies got any ideas :?:

Shirley
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Postby shirl1 » Fri Feb 09, 2007 11:31 am

Hi missj, thanks for your suggestions. I have been thinking along the same lines myself and discussing it with the others i know with the same problem. My worry is firstly the filler going lumpy and secondly i have quite high cheekbones anyway and i am only small, big cheeks, however fashionable, would look odd on me i think, but who knows till they try.
The other thing that worries me is if there is such a simple answer why do no docs suggest it?
Only one way to find if it works really isnt there?
Shirley
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Postby MissJ521@aol.com » Fri Feb 09, 2007 12:31 pm

Hi Shirl,


Well, the 'answer' I gave is in the realm of seeking out a 'novel approach' or a 'different approach' or even a "maverick" approach that makes some sense and for which some patients getting that thing have had some 'relief' this way who have sought out doctors to whom that approach ALSO makes sense to.

Those kind of approaches come from the patient "grapevine" more than they arise from an "official body" of doctors approving them or validating them. Some times, patient feedback in the realm of :

'I did this novel thing that was outside the "status quo" of what 'most' docs would suggest, and it worked for me.", can yield some "ideas" that lead to solutions.

There is never ever going to be any one solution that will work for everyone all of the time. But if a possible solution, is somewhere to be explored, I just wanted to offer a 'lead' as to how to go about exploring it.

As I said, there is no 'status quo' "solution" to the malar bag problem. Hence, you will be hard pressed to find an absolute 'answer' from docs. However, there is the possible solution that I have suggested (blending it in with filler) that looks like it could be promising (and through the patient grapevine has worked). So, it is something to be explored.





shirl1 wrote:Hi missj, thanks for your suggestions. I have been thinking along the same lines myself and discussing it with the others i know with the same problem. My worry is firstly the filler going lumpy and secondly i have quite high cheekbones anyway and i am only small, big cheeks, however fashionable, would look odd on me i think, but who knows till they try.
The other thing that worries me is if there is such a simple answer why do no docs suggest it?
Only one way to find if it works really isnt there?
Shirley
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shirl

Postby MissJ521@aol.com » Fri Feb 09, 2007 12:32 pm

Hi Shirl,


Well, the 'answer' I gave is in the realm of seeking out a 'novel approach' or a 'different approach' or even a "maverick" approach that makes some sense and for which some patients getting that thing have had some 'relief' this way who have sought out doctors to whom that approach ALSO makes sense to.

Those kind of approaches come from the patient "grapevine" more than they arise from an "official body" of doctors approving them or validating them. Some times, patient feedback in the realm of :

'I did this novel thing that was outside the "status quo" of what 'most' docs would suggest, and it worked for me.", can yield some "ideas" that lead to solutions.

There is never ever going to be any one solution that will work for everyone all of the time. But if a possible solution, is somewhere to be explored, I just wanted to offer a 'lead' as to how to go about exploring it.

As I said, there is no 'status quo' "solution" to the malar bag problem. Hence, you will be hard pressed to find an absolute 'answer' from docs. However, there is the possible solution that I have suggested (blending it in with filler) that looks like it could be promising (and through the patient grapevine has worked). So, it is something to be explored.
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Postby shirl1 » Fri Feb 09, 2007 12:39 pm

Hi missj, i will definately look into it. When you say it enlarges the cheek area, are we talking a lot here or just marginally? As i say i am only small and dont want to look out of proportion.
Shirley
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Postby MissJ521@aol.com » Fri Feb 09, 2007 12:55 pm

Well, shirl,
If you have a bag or protrusion on the upper cheek area, blending it in involves 'pushing' out the area below it and in the vicinity of the protrusion. It's a form of VISUALLY "subtracting" by "adding".

We would be talking the amount needed to 'blend' it in and that depends on the extent of the protrusion and also whether or not adding volume ELSEWHERE to blend it would look 'good' on you. A doc with a good aesthetic 'eye' and the approach I suggest exploring, could give you more feedback as to the proportional changes you could expect. Your questiion is contingent on a visual evaluation which I can't do here as I have no idea what you look like.

Discuss those concerns in the process of consulting and "looking in to it".


shirl1 wrote:Hi missj, i will definately look into it. When you say it enlarges the cheek area, are we talking a lot here or just marginally? As i say i am only small and dont want to look out of proportion.
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malar bags

Postby barbt5343 » Fri Feb 09, 2007 1:41 pm

hi shirley,
by now you have no doubt read the dr.'s answer to your question. i too have a mild problem with the bags. it is basically a family trait. i have asked numerous surgeons about it, and they all give the same answer....leave them alone. they advise that until an approach is proven to work well, you can be in a lot more trouble if you try and eliminate them.
can you do any makeup "trick" to help the look?or you could put on 50 lbs and fill out your cheeks naturally. hahahahaha just kidding.
when are you going to your sister's? hope to hear from you from time to time. barb
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Postby DCNGA » Sat Feb 10, 2007 7:42 am

MissJ, just wondering if you are a surgical nurse? You seem to have quite a bit of knowledge regarding PS and medical terminology than the average person.

I'm 99% sure I have the malar/festoon condtion. I will find out for sure when I return to my PS in two weeks. You and I discussed this on the laser discussion string.

The laser has "hollowed" out my under eye area more than pre-op due to the uneveness of my skin at this time. Hopefully some of that will resolve as the skin layers build up and collagen is rebuilt (if that ever happens--I have my doubts). Due to this unevenness and depressed area under my eyes, the malar mounds are much more noticable than I feel they would be otherwise.

If they are malar/festoons, I am not willing to have fat grafts or anything else done to my eyes as I'm concerned it would only worsen the problem--plus none of it would be permenant if my understanding of fillers is correct. Who wants to have contiunous injections of whatever under their eyes, ad infinitim? Surely scarring would come into play at some point along the way of repeated procedures in the delicate under eye area, or am I mistaken?

I should have left well enough alone with regard to under my eyes, even if the laser played no part in the festoons. I do not like any of the results from the erbium and regret having had it done.

:?

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Postby MissJ521@aol.com » Sat Feb 10, 2007 8:16 am

Not a surgical nurse but a patient of PS who is also MIT grad and has been collecting info about PS for the past 25 years. Basically, I'm the 'type' of person for whom it's easy to 'digest' a lot of medical/technical info especially stuff that RELATES to ME. LOL.

Keep in mind, my focus on THIS string has to do with a malar mound where the person is bothered by somewhat of a "step off" or demarcation BELOW it. That situation puts the area to augment more on the CHEEK. Augmenting the cheek with soft tissue filler is an easier task than augmenting the lower lid area.

Again, I'm discussing a circumstance where the aesthetic problem relates to a demarcation BELOW the malar mound: somewhat of a step off or discontinuous convexity of the cheek area. That is to say, something where augmentation to the CHEEK area could 'blend in' the mound.

Note that you say that your situation; 'hollowing of lids' relates to the area ABOVE where a malar mound could be. Although I certainly AGREE that your concerns with augmenting the lower lid are well warranted, what you describe relates to a different set of circumstances from what I'm focusing on here.

Augmenting the lower lid area with soft tissue filler is a 'different can of worms' than augmenting the cheek area. So, ya, I would say your concerns about filling the lower lid region are valid.

DCNGA wrote:MissJ, just wondering if you are a surgical nurse? You seem to have quite a bit of knowledge regarding PS and medical terminology than the average person.

I'm 99% sure I have the malar/festoon condtion. I will find out for sure when I return to my PS in two weeks. You and I discussed this on the laser discussion string.

The laser has "hollowed" out my under eye area more than pre-op due to the uneveness of my skin at this time. Hopefully some of that will resolve as the skin layers build up and collagen is rebuilt (if that ever happens--I have my doubts). Due to this unevenness and depressed area under my eyes, the malar mounds are much more noticable than I feel they would be otherwise.

If they are malar/festoons, I am not willing to have fat grafts or anything else done to my eyes as I'm concerned it would only worsen the problem--plus none of it would be permenant if my understanding of fillers is correct. Who wants to have contiunous injections of whatever under their eyes, ad infinitim? Surely scarring would come into play at some point along the way of repeated procedures in the delicate under eye area, or am I mistaken?

I should have left well enough alone with regard to under my eyes, even if the laser played no part in the festoons. I do not like any of the results from the erbium and regret having had it done.

:?

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Postby DCNGA » Sat Feb 10, 2007 10:00 am

Actually, I do have a demarcation line between where the malar mounds sit on my cheekbone and where the erbium was done. I now have a these bags sitting on my cheek bones and then I have the area that is "lower" because of the skin layers not having regrown. I have full blown bags, that like you previously said may be from the fl, on my cheek bones made much more noticable (demarcation line) by the fact that my under eye area is more hollowed out than ever before from the erbium.

I know, I'm very focused on this entire erbium issue but it just galls me that I now have to deal with something (healing time, skin unevenness, and wearing heavy concealer) that I could have completely avoided--plus the demarcation line making the malar mounds 10 times more evident!!!

Woe is me on this subject.

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Postby MissJ521@aol.com » Sat Feb 10, 2007 10:50 am

Well, attempted correction for the type of discontinuity you describe is in volumizing the surrounding areas to blend in more. Malar bags are usually places that hold edema (fluid) and are hard to remove. That's why PSs agree that they are hard to treat which is true when thinking in terms of removing them.

However, volumizing the lower lids is not easy and does present risks. The best way, in my opinion, to avoid the risks of volumizing the lower lids is to avoid procedures that DE-VOLUMIZE them.

I think that people with bags under their eyes should consider volumizing the area below the bags to blend them in. For excess skin to lower lids, I think a scalpel (in hands of good doc) used to excise ONLY skin has less of a "wild card" than a laser. However, as you may realize, much of laser MARKETING has to do with APPEALING to patients wishing to "avoid the knife".



DCNGA wrote:Actually, I do have a demarcation line between where the malar mounds sit on my cheekbone and where the erbium was done. I now have a these bags sitting on my cheek bones and then I have the area that is "lower" because of the skin layers not having regrown. I have full blown bags, that like you previously said may be from the fl, on my cheek bones made much more noticable (demarcation line) by the fact that my under eye area is more hollowed out than ever before from the erbium.

I know, I'm very focused on this entire erbium issue but it just galls me that I now have to deal with something (healing time, skin unevenness, and wearing heavy concealer) that I could have completely avoided--plus the demarcation line making the malar mounds 10 times more evident!!!

Woe is me on this subject.

D
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