Festoons and Malar Bags | 18 March 2025
At the Jonathan Britto Clinic, we understand the distress that eyelid festoons and malar bags can cause. These often misunderstood and under-treated features of facial ageing result in a tired, puffy, and shadowed appearance, particularly around the lower eyelid and midface.
The Papillon Procedure™ is Jonathan’s signature solution for these concerns—a sophisticated, scar-concealing surgical technique designed to restore the youthful relationship between the lower eyelid and cheek. No fillers. No fat injections. Just a beautifully natural, long-lasting result using your own anatomy – repositioned, not replaced.
What Are Festoons and Malar Bags?
Festoons and malar bags are two related but distinct aesthetic conditions:
Malar bags are bulges that appear on the upper cheeks, below the lower eyelids. They are usually caused by fluid retention, weakening facial muscles, and ageing, and they tend to be more prominent in the morning due to gravity and overnight lymphatic pooling.
Festoons are more advanced than malar bags. They appear as folds or drapes of sagging tissue, often forming a “Y shape of shadow” from the lower eyelid to the corner of the nose. These folds are created by laxity of the eye closing muscle (orbicularis oculi muscle) and soft tissue descent from the midface.
Festoons are a key hallmark of facial ageing, and their alternating light and shadow patterns give the impression of deep fatigue and swelling. Standard lower eyelid surgery (blepharoplasty) alone is often insufficient to address festoons—which is why Jonathan developed the Papillon Procedure™.
The Aesthetic Problem
Before Surgery:
– Heavy upper eyelid folds pressing on the eye lashes
– Ballooning lower eyelid bags
– ‘Y-shape’ of shadow from lid to cheek
– Draped festoons casting persistent shadows from the eyelid to the mid-cheek
– Volume and contour loss in the midface
– Volume and contour loss in the lid-cheek junction (extended tear trough)
After the Papillon Procedure™:
– Bright, open eyes in all phases of movement
– Naturally shaped lower eyelids
– Smooth lid-cheek junction with youthful contour
– Elimination of festoons and midface shadowing
– Softened nasolabial lines
– No visible scars, and complete restoration of dynamic function
What Is the Papillon Procedure™?
The Papillon Procedure™ is Jonathan’s signature surgical approach to correcting festoons and midface sagging. Named after the butterfly-like area it rejuvenates— upper to lower eyelid and cheeks in a mask-like zone – it’s a powerful, scar-concealing, and anatomically harmonious solution that:
– Restores lower eyelid support and contour
– Lifts and repositions descended midface tissues
– Eliminates festoons and malar bags
– Enhances the smooth light reflex across the midface
Requires no fillers, no added fat, and minimal excision.
Instead of masking volume loss with injected substances, the Papillon Procedure™ repositions and secures the natural fat pads, muscle layers, and skin envelope to their youthful anatomical location.
How Is It Performed?
The Papillon Procedure™ is carried out via a hidden incision just under the lower eyelashes, similar to a lower eyelid blepharoplasty. Through this access point, Jonathan can:
– Gently elevate the lower eyelid tissues
– Release and lift sagging eye lid closing muscle (orbicularis muscle) and deep cheek fat
– Secure the midface tissues at their youthful height and angle
– Close incisions with fine sutures that heal invisibly
The procedure is performed under Twilight sedation and typically patients return home the same day.
The Papillon Procedure™ is ideal for patients who:
It is particularly suited to midlife patients who are noticing the effects of gravity, fluid retention, and midfacial descent but who are not ready for, or do not require, a full facelift.
Recovery and Results
Most patients experience mild to moderate swelling and bruising, which resolve over 10–14 days. The results become visible as early as 3 weeks, with continued refinement over 2–3 months.
There is no tightness or pulling—eye movement and facial expression remain natural and fluid, with the added benefit of smoother, lifted contours and elimination of midface shadowing.
Key Benefits:
– No visible scars
– Restored comfort and confidence
– Natural expression preserved
– No added filler or foreign material
– Youthful light reflection across the midface
Why Not Fillers?
Many patients with festoons or malar bags are first treated with injectable fillers, often with disappointing or worsening results. Fillers can obscure the problem temporarily, but when used inappropriately, they may exacerbate swelling, distort natural anatomy, and lead to a “puffy” or unnatural appearance.
The Papillon Procedure™ avoids these pitfalls by relying on repositioning—not volume replacement—to restore facial balance and structure.
At the Jonathan Britto Clinic, we combine technical excellence with aesthetic sensitivity. Jonathan’s background in both reconstructive and aesthetic facial surgery, coupled with his bespoke approach to every patient, ensures that your Papillon Procedure™ is designed specifically for your unique anatomy, goals, and lifestyle.
Book your consultation for the Papillon Procedure™ today at the Jonathan Britto Clinic, and discover a truly bespoke solution for eyelid festoons and midface rejuvenation.
