title: [Treatment of malar mounds by direct excision].
abstract: OBJECTIVE
  The treatment of malar mounds is challenging. We report a case series of direct excision of malar mounds and review the existing literature.
  
  
  METHODS
  The procedure is carried out under local anesthesia with light sedation. A pinch test allows to estimate the width of the resection. The skin is resected, and if needed, some of the sub-orbicularis oculi fat. The orbicularis muscle is not closed, and the skin is closed in two layers.
  
  
  RESULTS
  Eight patients were treated by the same surgeon between January and December 2013. The ages ranged from 41 to 74, with an average of 53. The patients were highly satisfied. The results were considered excellent for 5 patients and good for 3. There were no complications, in particular no scleral show, no ectropion, and no hematoma.
  
  
  CONCLUSIONS
  Direct excision of malar mounds is simple, efficient, and reproducible. The scars are most often inconspicuous, in particular in the elderly.
authors: Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France. Electronic address: rani.makoul@gmail.com.
authors: R
authors: R
authors: Makhoul
authors: Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors: W
authors: W
authors: Noël
authors: Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors: E
authors: E
authors: Royer
authors: Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors: J
authors: J
authors: Szwebel
authors: Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors: P
authors: P
authors: Levan
mesh_terms: D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D017060:Patient Satisfaction; D010781:Photography; D012189:Retrospective Studies
keywords: Blepharoplasty; Blépharoplastie; Direct excision; Malar mounds; Poches malaires; Résection directe