2 years after Restylane injected in tear troughs, I'm left with 2 small mounds on the top of each cheek. Possible festoons?

Injector are often afraid to use "too much" hyaluronidase. The filler product needs to be aggressively removed in the festoon area. I think the use of threads in the festoon area was not a good choice. What you need at this point will very much depend on precisely what is going. For that reason, there is no substitute for a detailed personal examination. Anyone who advises what you need without that detailed personal examination should be regarded with suspicion. Stop digging a bigger hole for yourself my getting procedures that are only making your worse.

Often people mistake their tear trough for malaria bags and vice versa. I suspect what has happened is as the filler has faded and you have aged two years, your molar bags have become more evident. Filler only has a limited role to play in the treatment of malaria bags so be cautious about repeating the procedure. Hope that helps. Adam Goodwin

It looks like they are festoons. You should look into considering the possibility of treating these with CO2 laser.

It is hard to treat festoons. I have had some success using Infini for these. Other docs are using CO2 or Erbium for these. I would make sure all the filler is out with one last injection with hyaluronidase. Filler can persist for years in this area.