Malar bags or festoons are very difficult to treat. Surgical removal requires an extended lateral lower eyelid incision which is very visible through which a modified cheek lift can be done.In my opinion the best treatment for malar bags is dermal filler injections into the depression below ...
It will ppay for the upper lids in some case but not the lower lids.You have to have visual fields studies done before your surgery and they have to show significant visual field loss before they will pay.
I would consider a small surgery where I release the lower eyelid retractors. This allows the eyelid to naturally elevate. The release is done from a small incision on the inside of the eyelid. What this does is it creates more a space between the muscles and their attachments....