For years, the only real answer to stubborn under-eye bags, festoons, and malar mounds was surgery. Dr. Kaveh Karandish's advanced EndoLaser protocol is changing that — and it was just featured in an international medical journal.
Dr. Karandish's case study, "A New Non-Surgical Approach to Eye Bags, Festoons and Malar Oedema," appears in the January/February 2026 issue of PRIME — the International Journal of Aesthetic and Anti-Ageing Medicine (pages 28–29). PRIME is a peer-respected publication read by aesthetic physicians worldwide.
Why Under-Eye Concerns Are So Hard to Fix
The area beneath the eyes is one of the most delicate — and most visible — parts of the face. When skin loses elasticity and small pockets of fat push forward, the result is the tired, puffy look we call eye bags. Festoons and malar mounds sit slightly lower on the cheekbone and are even more challenging, because swelling and laxity are involved.
Traditional options each come with trade-offs. Surgery can deliver results but involves longer recovery, higher costs, and greater potential risks. Radiofrequency devices can help, but they carry a risk of superficial skin pigmentation and may not be as precise or minimally invasive.
The EndoLaser Breakthrough: How It Works
The procedure begins with local anesthesia. A tiny fiber-optic — as small as 200 to 300 microns — is then introduced beneath the skin to deliver laser energy exactly where it's needed.
The 1470 nm wavelength is special: it has a strong affinity for both water and fat. That means it can tighten and rejuvenate skin by shrinking collagen through a gentle thermal effect, and at higher settings, it can initiate lipolysis — melting small fat pockets to contour the under-eye area. This dual action is also what makes it a safe option without the risk of hyperpigmentation in the tissue.
— Dr. Kaveh Karandish, MD, in PRIME Journal
Real Results: Before & After
These results, published alongside the PRIME Journal case study, show the progression after Endolift treatment for eye bags — no incisions, no surgery.
How It Compares to RF Microneedling & Surgery
Before adopting the EndoLaser protocol, our practice used radiofrequency microneedling devices such as Agnes RF and Morpheus8 for under-eye concerns. Those tools still have their place — but in Dr. Karandish's published experience, the degree of improvement possible with the EndoLaser in some cases of eye bags, even up to 70% or more, was never achievable with those devices.
- Versus RF treatments: more precise, more minimally invasive, and without the risk of superficial skin pigmentation.
- Versus surgery: no incisions, lower cost, fewer potential risks, and dramatically less downtime.
- Enhanced results: we often combine the EndoLaser session with external resurfacing and fractional laser options to address laxity and overall skin quality at the same time.
What to Expect: Sessions, Downtime & Results
Because the periorbital area is so delicate, this technique requires advanced-level experience with the Endolaser. Energy is typically divided over two to three sessions — enhancing safety while keeping downtime reasonable.
With our method and healing protocol — which utilizes topical healing boosters, masks, and oral options — downtime with each session is usually less than five days. For cases with significant under-eye bags, delivering higher energy to induce lipolysis can lead to more permanent results.
Why Experience Matters — and Why PCH MedSpa
The under-eye area leaves no room for guesswork. Expertise in this method is crucial for achieving optimal results, and Dr. Karandish is nationally recognized as one of the leaders in this treatment — with 700+ Endolift laser treatments performed and the founder of the Endolift Training Academy, where he trains physicians from across the country.
When a physician's protocol is published in an international aesthetic medicine journal, it reflects a level of mastery you can trust with the most delicate area of your face.
Ready to Refresh Your Eyes — Without Surgery?
Find out if you're a candidate for the EndoLaser approach to eye bags, festoons, and malar edema. Dr. Karandish personally evaluates every treatment plan.
Book Your Consultation! Or call us at 949-242-9166 · Corona Del Mar, Newport BeachFrequently Asked Questions
What is the EndoLaser treatment for eye bags?
It's a minimally invasive laser protocol using the Lasemar 1500 (Eufoton). A tiny fiber-optic is inserted under the skin through a needle prick to deliver 1470 nm laser energy that tightens skin and can melt small fat pockets — no incisions or stitches.
What are festoons and malar edema?
Festoons (also called malar mounds) are pockets of swelling and lax skin on the upper cheekbone, just below the under-eye area. Malar edema is fluid retention in the same region. Both are notoriously difficult to improve with creams, fillers, or standard treatments.
How is this different from Morpheus8 or Agnes RF?
RF microneedling treats from the surface and carries a risk of superficial pigmentation. The EndoLaser works beneath the skin with greater precision, and in Dr. Karandish's published experience, some eye bag cases improved up to 70% or more — results not previously possible with those devices.
Is the treatment painful?
The procedure is performed under local anesthesia infiltrated into the treatment area, so discomfort is minimal for most patients.
How many sessions will I need?
Treatment energy is typically divided over 2–3 sessions. This enhances safety in the delicate periorbital area and keeps downtime shorter after each visit.
How much downtime should I expect?
With our healing protocol — topical healing boosters, masks, and oral options — downtime is usually less than 5 days per session.
How long do results last?
Results can last anywhere from 3 to 5 years. In cases with significant under-eye bags, delivering higher energy to induce lipolysis may lead to more permanent results.
Is it safe for the under-eye area?
In experienced hands, yes. The 1470 nm wavelength has a strong affinity for water and fat, allowing precise contouring without the pigmentation risks associated with some RF devices. Advanced expertise with periorbital anatomy is essential — which is why candidate selection and physician experience matter so much.
Am I a candidate?
Good candidates typically have under-eye bags, festoons, malar mounds, or skin laxity and want meaningful improvement without surgery. Proper candidate selection is key, so an in-person evaluation with Dr. Karandish is the best first step.
Can it be combined with other treatments?
Yes. We often combine the EndoLaser session with external resurfacing and fractional or ablative laser options to further improve laxity and overall skin quality.
What satisfaction rates do patients report?
Our practice reports a patient satisfaction rate of 70–80% with this treatment, as published in PRIME Journal.
Where is this treatment available?
At PCH MedSpa — Aesthetic and Wellness Center in Corona Del Mar, Newport Beach, CA. Dr. Karandish is one of the national leaders in this technique and trains physicians across the country through the Endolift Training Academy.
Individual results may vary; this content is educational and not a substitute for a medical consultation.
