I'm not sure if I have festoon or eye bags. How can I treat them? (Photo)

You have a bit of both.  The fat which is under the eye is prolapsed orbital fat.  This can be repositioned into the tear trough with a blepharoplasty.  Or you can put some filler into the tear trough which will help to smooth out the area and make the fat pads less visible.  The malar fat pad is the one that is a little lower and to the outside.  This is an aging change and can be tough to eliminate.  With a blepharoplasty we try to pull this fat pad up so you don't see  it as much.  Some laser resurfacing over it will help to tighten the skin and smooth it out. Adding some filler around it will also help to mask it.     

You have herniated fat on both lower eyelids, as well as loss of fat in the tear trough and orbitomalar groove.  You have a bit more complicated situation in that you need the eyelid fat removed, yet you need fat replaced in the tear trough and orbitomalar groove region.  For this reason I would recommend a lower lid blepharoplasty to remove the eyelid fat, and fat grafting to the tear trough and groove.  

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately. All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Thank you for the question, because it is one many patients have. The puffiness of the lower eyelids is caused by fat herniating forward. The slight mounds beneath them are festoons. There are several different ways to deal with the bags, ranging from fillers to surgery. The festoons are more difficult manage. Excision or laser skin resurfacing might improve their appearance. Make an appointment with an experienced oculoplastic surgeon for evaluation and guidance. Good luck,

You have both lower eyelid bags and festoons. The treatment is very different. Lower eyelid bags are treated by lower blepharoplasty while there are various okay options for festoons. See an oculoplastic specialist.

You photograph suggests you have booth. A lower lid lift (Blepharoplasty) will take care of your lower lid fullness -"Eyelid Bags". Festoons or "malar mounds" are more difficult to take care of - with RF or laser devices probably the best to improve these troublesome areas.

Although an in-office examination or standardized photographs are the best way to determine and diagnose eyelid bags and festoons, your photographs illustrate you more than likely have eyelid bags.  BUT, it would be very, very important to know if you have ever had filler injections underneath your eyes, or in your upper cheeks because these can often simulate eyelid bags, malar mounds and worsen festoons.IF not, it appears you have eyelid bags and malar (upper lateral cheek) swelling (edema) sometimes called malar mounds. You do NOT have festoons (which are different than malar mounds) and are actually an advanced anatomic condition which includes very saggy skin with redundant orbicularis oculi muscle (simply Google "severe eye festoons" to see the difference).Malar mounds that are comprised mostly of swelling/fluid can be significantly improved by watching your diet (sodium less than 1500 mg per day) and making sure your hormones (e.g., thyroid) and other electrolytes are in proper balance.  Treatments such as targeted Ultherapy and even laser resurfacing may have a role.  I recommend that people stay away from hyaluronic based fillers in this area (because they tend to attract water) and use Sculptra or Radiesse instead.Lower eyelid bags are treated best with surgery, and the attached link provides more information.I hope this helps.

Festoons are "bags" in the upper cheek area that result from edema (fluid build up) in the cheek tissues. These are separate from the fat pads in the lower eyelids. Soft tissue fillers can be helpful in camouflaging the contour abnormalities, but can also lead to more fluid retention. Non-surgical heat-based technologies, such as ThermiSmooth, Pelleve, or Ulthera may be a better option.

You may want to talk to a doctor to see if fillers may work for you. Maybe talk to them about Belotero, or what other fillers they recommend. this is something that you do not need surgery for unless it is necessary

Thank you for your question.The upper pouches just under your eyelashes are what many term "eye bags".  The lower ones on the cheek are called festoons or malar mounds.  They are a result of fat shrinkage in your upper cheeks from normal aging.  Replacement of volume can improve the contours, using either injectable fillers or your own fat.  Blepharoplasty surgery is effective for reduction of the eye bags by repositioning the fat bulges.  Good luck!