Festoons are overhanging folds of skin and muscle that create an unsightly appearance to the lower lids and their transition to the middle face. Some people think of festoons as severe under eye bags. There is no simple surgical correction for this aesthetic problem.  Procedures used to remove eyelid festoons include, laser skin shrinkage, aggressive (so called extended) lower blepharoplasty, the addition of midface lifting, lower lid muscle tightening, the injection of various chemicals for shrinkage, and “direct excision.”

Dr. Guy Massry, who is an eyelid surgical specialist (oculoplastic or ophthalmic plastic surgeon), in Beverly Hills, California, has attempted all treatments for festoons.  He has found that in almost all cases patients are displeased with their results.  This is because, often the treatment can be worse than the original problem. The methods of treatment described above can lead to prolonged healing (often 6 months or more), a change in the shape of the eye/eyelid, changes in color or texture of the skin, and an unnatural appearance.  Dr. Massry stresses to patients that this is not because of bad surgery or other intervention, rather it’s because the problem has no good solution. Dr. Massry’s plea to patients is to either live with the problem or do the most consistent procedure to address it.

With our current state of knowledge Dr. Massry strongly believes the best procedure to correct festoons is “direct excision.” Simply stated this means to cut the festoon out.  The fear of this procedure is the formation of an obvious scar.  Dr. Massry has shown, in a recent scientific publication, that skin scars are barely noticed when appropriately injected with scar modulators. Dr. Massry has had wonderful results with direct excision of festoons in the appropriate patient.  Please see the example below.


festoon blog

Note prior to surgery (left) frontal view above and side view below.  After surgery results (right) of the same views. Prior to surgery the festoons are obvious.  After surgery they are significantly improved without obvious scar and there is no makeup on to hide a scar.  A conservative outer brow lift and upper eyelid blepharoplasty (skin and fat removal) was also performed.

Contact Dr Massry today!

If you are interested in treatment for eyelid festoons, please contact Dr. Massry’s office at 310-657-4302 or fill out the contact form on our website.