Malar bags or ‘festoons’ are swollen bags that appear under the eyes affecting the lower eyelid and cheek junction. Malar bags are a common feature of ageing of the midface, fat loss and fluid retention around the cheekbones can cause the skin to sag and make Malar bags appear pronounced.
Doxycycline is an antibiotic which is also an effective sclerosant agent. Doxycycline injections into the malar bags cause localised inflammation which can help the ‘bag’ to ‘stick’ down reducing the space for fluid to gather inane thereby reducing the appearance of the malar bag.
Doxycycline for malar bags is a type of sclerotherapy, which you may have heard of in other medical settings, such as varicose veins, where it has been used for many years. Sclerotherapy essentially means to stick together, in this application the Doxycycline injections into the malar bags cause them to stick together, making the space in the bag smaller, or ideally closing it completely, preventing the further accumulation of fluid.
Should doxycycline be agreed upon as the most suitable treatment, skin at the treatment site will be cleansed thoroughly. Doxycycline is then injected directly into the malar bag through a fine needle. This takes a minute or so each side.
Our initial findings with this treatment have been positive, and this is supported by other studies in medical literature which have found this to be a safe and effective treatment for malar bags. Following treatment, patients should expect to experience a reduction in the size and visibility of under eye bags.
The doxycycline is administered via an injection to the malar bag area, which takes roughly a minute each side. Patients have described the injection as a ‘bee-sting’ which passes quickly following the procedure.
Some downtime is to be expected following doxycycline for malar bags treatment, the potential symptoms are outlined below;
0-4 hours post-procedure-
Patients may experience the sensation of heat at the treatment site. This can be alleviated with a cold compress (fridge temperature, not ice cold). Cooling eye masks may also be used. Occasionally paracetamol is required. Avoid using make-up, face or eye creams on the day of treatment.
0-24 hours post-procedure-
The area surrounding the injection site will be red and significantly swollen. Elevating your head and sleeping with extra pillows on the night after treatment will help this to settle.
1-7 days post-procedure-
Make-up and eye creams can be commenced the day after treatment. The treatment site area will remain visibly swollen, gradually improving in this first week post-treatment. After 7 days patients may commence lymphatic drainage techniques, as discussed at consultation.
0-14 days post-procedure-
As is the case with any injection, there is the potential of bruising at the treatment site, which may persist for up to 14 days after treatment.
Application of local anaesthetic at the treatment site ensures total comfort for the duration of the procedure
The treatment area is thoroughly cleansed, before doxycycline is injected directly into the malar bag
Following treatment, patients should expect to experience a reduction in the size and visibility of under eye bags
Immediately after the treatment the undereye area will be swollen and red. Bruising at the injection site may occur and cannot be predicted.
For optimum results, up to 3 doxycycline treatments may be required, with annual maintenance thereafter