Q. I have a problem with what I think are called malar mounds – essentially, > bulging areas at the top of the cheek but below the precise sub-orbital > eye > area. I have had three consultations with three different surgeons and > have had > three different pieces of advice. Basically, the problem comes down to > whether the mounds consist of fat or water, and the surgeons I have seen > do not > agree on which it is. Obviously, this is a very important point; I have > been > advised that if they are in fact water then surgery to correct them would > be > useless and would in fact make the condition worse. I have also had a previous bletheroplasty which may (according to some surgeons) have caused the problem in the first place. I am therefore looking > for > advice from a surgeon who has a specific and in-depth knowledge of this > problem/area and who could therefore answer this issue definitively so > that I > can decide whether or not surgery is appropriate. However, as virtually all surgeons give ‘facial’ surgery as a specialty, I’m finding it impossible to find a surgeon with a particular speciality in this very specific area. > > As the BAAPS website does not list areas of surgeons’ specialities in such > detail, could you assist me > in my search? Thanks in advance. >
A. Thank you for your inquiry. As far as my knowledge goes, malar oedema is not induced by blepharoplasty surgery, but the area again become more visible after the eyelid bags have been corrected. I am not aware of for definitive treatment for this problem, and in most instances I advised patients that fat transfer around it may improve the appearance. It is possible to use 3-D photography and simulation to define how much of a change is needed for this purpose. Another aspect is that food allergies may be part of the increased visibility of the malar edema, and a consultation with a nutritionist that has an interest in food allergy issues may also be of help.
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