What would be best result to treating my festoons. I am considering laser and blepharoplasty. (Photos)

Looking at the photos, I think best treatment would be filler injection around the "festoons" as there is hollowness present.

Hello,This is a common and challenging condition.  In our practice, we have successfully "improved" the appearance using dermal fillers if a patient is not a good candidate for, or is averse to, a surgical option.  It's understandable that your previous filler experience was not satisfactory, as many injectors may not realize the best approach or set the correct expectations of improvement. Being that the issue is the festooning/bulge, the goal is to camouflage this by blending the two areas or bridging the gap, so to speak.  Having an in-person consultation for both options (surgery vs filler) may be worthwhile in finding a better outcome. Lastly, lasers will not improve this condition.

Lower eyelid festoons are a difficult problem, but in your particular case, are not as significant as other festoons. Lower eyelid blepharoplasty will do nothing for festoons, including yours.  Significant festoons are usually treated with direct surgical excision, but in your case, micro liposuction would improve your situation.

are more related to malar bags and the small crease that you show is probably best managed with fillers done using the proper techniques.  No legitimate surgeon would offer traditional CO2 laser in your situation and blepharoplasties remove excess skin, which I do not appreciate any at all.  A dermal filler placed in the proper plane should smooth the crease out.  If you prefer something else, ThermiRF could be done to help shrink the skin to diminish the crease.  See a board certified plastic surgeon, facial plastic surgeon, or oculoplastic surgeon for more information on how best to manage this

Hello tadaniels2007,
I dont know if lasering will give you the bang for the buck so to speak. The problem is either fluid or tissue laxity under the skin. If there is an underlying reason for the festoons such as thyroid disease then any treatmet including surgery might not give you the ultimate result. First step is to find out the underlying cause of your festoons. If you choose to address this I believe the right type of filler augmentation is your best noninvasive option with the least complication. Your previous filler experience certainly can shine some doubt but rest assured it can work. The option with the best longevity and most natural result would be a simple surgical approach. My suggestion is to seek out an experienced oculoplastic surgeon to discuss your risks, complication and benefits.
Cheers

Thank you for your photos. Festoons can be difficult to treat. They are due to a combination of the deep ligamentous attachments to your face, as well as fluid and fat in that area. In my experience an extended blepharoplasty yields the best results. Superficial treatments such as lasers or deep peels are not able to treat the underlying causes in the deep tissue. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee