Treatment of festoons by direct excision

Background: Festoons are redundant folds of loose skin, muscle, fat, and interstitial edema which extend from beyond the lateral cheek often past the midpupillary line, or even from canthus to canthus. Despite the fact that various treatments have been suggested for festoons, this entity still remains difficult and frustrating to treat. Objective: The authors report the results of their approach for the treatment of festoons by lower lid tightening and direct excision. Methods: Fifteen eyes of 8 patients with festoons were treated with direct excision, between 2009 and 2011. Results: No major complications were observed in any of the patients in this series. Both the patients and surgeon were very satisfied with the results with minimal to no visible scar. Conclusions: Lower lid festoons have remained frustrating to treat. Our experience suggests that direct excision of the festoons can provide a successful, reliable and safe therapy.