I have deep grooves, possibly festoons on my upper cheeks. What are my options? (photos)

Schedule a consultation with a board certified plastic surgeon in your area to be assessed in person and discuss fillers to address the under eye area, upper cheek and the transition between the two. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

I would use Voluma, which is generally used for cheek augmentation to fill those deep grooves more laterally. You can expect 9-12 months duration and sometimes even longer.  For the medial lines or tear trough I would inject more finer fillers such as Restylane or Belotero because of the thin eyelid skin in that region to prevent surface irregularity.  Duration can be expected to be one year in that region.  For the surgical option, I would need to examine the whole face to determine if you have true mid face descent versus festoons; mid face lift approached thru an extended lower blepharoplasty approach would be an option.  Another surgical option would be fat transfer obtained from the abdomen/thigh and injected into the deep groove.

Thank you for the photo and your question. This is a highly sensitive area and all treatment options have benefits and risks. I use fillers routinely in the midface and under eye area in patients around your age. For the tear trough, I generally use Restylane. Lower down on the cheek, where the line continues further toward the angle of the jaw, you have a "malar groove" this requires use of a thicker filler placed more deeply. I like Voluma or Restylane Lyft (f.k.a. Perlane) for this area. Best of luck!