Contours and Confusions: A Review of Malar Mounds, Malar Edema, and Festoons

Malar bags, including malar mounds, malar edema, and festoons, represent a spectrum of conditions which pose both aesthetic and therapeutic challenges. Their overlapping anatomy and multifactorial etiology complicate diagnosis and treatment. This review aims to evaluate the current understanding of these terms, propose their clinical characteristics and pathophysiology, and evaluate approaches to management. While a range of treatment options have been suggested, the supporting evidence remains limited, and treatment must be tailored to each individual case.