Imagine the part of the skin close to the lower eyelid that begins to droop, forming something resembling a crescent moon. This is called “scalloping,” and although its appearance is unique, there is still much we don’t understand about why it happens. We are not talking about the bulging lower eyelid or eye bag. It can be frustrating for both the person who has it and the physicians who try to treat it. In this article, we will explore what we know about scallops and how we currently handle them.


Scallops are a kind of lump or swelling that can appear on our cheeks, just below the eyes. We don’t fully understand why they happen, but they seem to be related to aging and the way the skin and muscles in that area change over time.

Interestingly, some people don’t realize they have a scallop until someone points it out to them, or even worse, until after eyelid surgery that makes it more noticeable.

But what really causes these scallops?

It appears to be a combination of loose skin, weakened muscles around the eyes and ligaments in that area losing their strength. All of this can cause the skin and muscles to slide downward, forming a bulge in the cheek. Sometimes fluid can even accumulate in this area, contributing to the puffy appearance.

I hope this helps to understand a little better what scallops are and why they can be so puzzling. In the remainder of this article, we will explore more about how they are treated and what we can do to manage this unusual and often bothersome condition.

Characteristics of the Festoons

Scallops are like a sponge that can retain fluid in the skin under the eyes, giving a puffy appearance. But why does this happen? Here are some key points:

1. Relationship with the Lymphatic System:
The scallops seem to have a connection to our lymphatic system, which helps drain fluids in our body. This could explain why they swell in some situations, especially after certain surgeries.

2. Related Causes:
There are many conditions and situations that could cause or aggravate scallops, from inflammatory diseases and malignancies to allergic reactions to medications, cosmetics and sunscreens.

3. Relationship with Ocular Rosacea:
The inflammatory condition most commonly associated with festoons is ocular rosacea, a chronic inflammation of the skin around the eyes. In severe cases, it can lead to a disease called Morbihan disease, which causes a blockage in the lymphatic vessels.

4. Effects of Aging and Body Position:
Tissue laxity in the eyelids and cheeks can contribute to the appearance of scallops, and their appearance can change depending on whether you are standing or lying down. It is also interesting that scalloping can occur without visible signs of aging and in some people, even in early childhood.

5. Worsening in Certain Environments:
Festoons may worsen in patients with disorders such as thyroid problems, allergies, chronic kidney disease or liver cirrhosis.

Scalloping is a complex and multifaceted condition. Although there is still much to learn about their origin and treatment, they are known to be related to a variety of factors, from individual anatomy to inflammatory diseases and aging.

Personalized care and treatment are key to managing this condition that can be frustrating for both the patient and the plastic surgeon.

If you have scallops or know someone who does, knowing more about their nature and possible causes can help in choosing the right treatment. Consult with a plastic surgeon to discuss options and find a solution that is right for you.

Evaluation and Management of Festoons (Bags under the Eyes)

Festoons are those annoying bags that appear under the eyes and can give an appearance of tiredness or aging. Here we will explain why they appear and what can be done to treat them.

Why are scallops formed?

There are several reasons why someone might develop scallops. Some of the most common include:

Medications: Certain medications, such as aspirin or prednisone, can cause swelling in the eyelids.

Diseases: Problems such as heart, liver or thyroid disease may also contribute.

Allergies: If you are prone to allergies, this could worsen the swelling in that area.

Evaluation of festoons

Before treating these bags under the eyes, it is vital to understand what is causing them. This may include reviewing the medical history, performing specific tests, and careful observation of the affected area by a plastic surgeon.

Festoon management: Without surgery

Not all scallop treatments require surgery. Some non-surgical options include:

1. FillersThese can be injected into the surrounding areas to disguise the scallops, although this should be done with care.
2. Laser and Radiofrequency TreatmentsThese procedures can improve the appearance of the scallops by delivering a thermal lesion to the area, stimulating collagen.
3. Chemical PeelsUsing substances such as trichloroacetic acid, the appearance of the skin can be improved.
4. Tetracycline or Doxycycline injections: These substances have been used to reduce scallops due to their sclerosing properties.

Scalloping is a common concern for many people, but with proper evaluation and a variety of treatments available, there is hope for improving their appearance. If you are experiencing this problem, it is essential to talk to your plastic surgeon who can assess your situation and recommend the best treatment for you.

Characteristics of the Festoons

Scallops can be described as those annoying bags or wrinkles under the lower eyelids that sometimes appear with age or due to certain health problems. They are a concern for both the people who have them and the physicians who try to help them. Here we explain what they are, why they occur and what can be done about them.

What are Festones?

Scallops are like bags or folds in the skin under the lower eyelids, not dark circles or bags under the lower eyelids. They can give the face a tired, aged appearance and are especially difficult to treat. Many times, scallops are a source of frustration for people who have them, as they can limit the results of eyelid surgeries.

Why would the festoons occur?

Scalloping may be related to different factors such as genetics, aging, certain medical conditions and some medications. Sometimes, they can even be an allergic response to something in our environment.

Treatment Options

Fortunately, treatments for scallops are constantly improving. Some non-surgical methods can be tried, such as the use of drugs of the tetracycline family that have shown promise.

For those seeking more permanent solutions, there are a variety of surgical procedures available that can hide or even improve the appearance of the scallops. However, it is important to talk to an experienced plastic surgeon about the options and risks before deciding on a particular treatment.

Scallops are a challenge, but not insurmountable. With better understanding and advances in medicine, treatment options continue to grow and improve. Continued research will surely provide even more ways to address this vexing problem in the future.

If you’re dealing with scallops, you’re not alone. Talk to a professional about your symptoms and concerns, and together you can work on finding the solution that best suits your needs and lifestyle. With the right approach and treatment, you can look in the mirror and see a fresher, younger version of yourself.

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