I think these are malar bags? What can I do? Should I get surgery or fillers? (photos)

There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel, CO2), Renuvion (previously J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Dear M.A.S.MFestoons and Malar mounds are a medical condition in which the skin of the lower eyelid becomes significantly damaged, usually by the sun. This damaged skin can result in folds in the lower eyelids and can lead to swollen mounds on the cheeks. They often occur with age and are more common in people with lighter skin types.They are a difficult condition to treat but I've had success using lasers to improve lower eyelid festoons and malar mounds.I'll include some links below.I hope this was helpful. 

Eyelid fat bags are best corrected by surgery but there are some nonsurgical options that work sometimes. Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the malar or lower eye fat bags.I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of mini facelifts and eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

These are festoons. They are fluctuating swellings caused by accumulation of fluids as a result of a loss in elasticity and thinning of the skin.Surgery is a last resort as you will be substituting the swelling for a visible scar.The key to management is strengthening and thickening the skin. Typically, I'd put my patients on a retinol based skincare routine and then add on a course of CO2 laser tx or microneedling after 6-8 weeks.It's important to accept that the festoon are unlikely to completely disappear; treatment will only render them less obvious. And continuing skin care is is important.

Sometimes these products get away from the doctor and contribute to the festoon. I would be oh so cautious about surgery. It is a good way to get wrecked for life. Surgeons mean well but meaning well does not prevent them from getting surgical patients into trouble. You have prominent mid cheek groove. Sometimes, simply filling the groove with the right hyaluronic acid filler can beautifully manage the issue without complex surgery. If you have a history of cheek fillers, I would start by removing this.

From the photo it appears you have festoons.  They are difficult to treat but sometimes can be improved with laser treatments.  Sometimes filler can help, but if done incorrectly can actually make them appear more pronounced.  Surgery would be the last resort.  I encourage you to meet with an experienced board certified plastic surgeon for an evaluation.