Malar bags/fluid retention and fat pad herniation. Would this require lower blepharoplasty, or is there another option? (Photos)

Great question!
I think there are a couple of different options for each of your concerns.
1) Malar bags typically don't respond as well to surgery (ie blepharoplasty) unless the problem is excess muscle which needs to be removed (doesn't seem so in your case). Sometimes a resurfacing laser can be helpful in tightening this area a bit so it is less full.
2) Fluid retention can be secondary to excess sodium in your diet, allergies, poor sleep, or metabolic disorders (ie thyroid issues). Getting these addressed will likely help to some extent.
3) Fat pad herniation can be addressed with a lower blepharoplasty, however based on the photos I do not think this is contributing enough that I would recommend surgery.
Hope this helps and best of luck! Kyle Kimura, MD

Based on your series of nicely post photos, I would try a non-invasive option first in other words the end of lays one or two treatments once a month expect fees for treatment at 4000 to 5000 per treatment. This gives an opportunity to melt the fat through a puncture wound and tighten the skin and dissolve any excess fluid. Best of virtual consultant with.