I need help with festoons in NYC: I'm looking for nonsurgical options, any suggestions? (Photos)

Thank you very much for your question
there are two types of approach, the surgical and the non-surgical, either is no risk of treatment as long as it is performed by a professional, in the case of surgical removal of the bag that causes your dark circles will be performed by the internal mucosa of the lower eyelid, in case of non-surgical treatment we have advanced techniques for correction of the eyecup, the product that joins is hyaluronic acid or any Radiesse of the two is applied with techniques and safety entry points with a very small cannula, this cannula allows us to avoid damaging structures such as vessels and nerves and prevents bleeding or bruising.. Greetings from Cartagena Colombia!

Very difficult problem to treat! There are some good results with nano-fat grafts (stem cells) injection into this area which may help with discoloration and as a filler. In person consultation with a board certified plastic surgeon with experience in this technique is recommended. Good luck. 

Festoons and malar mounds have been a frustration for surgeons for many years. Thanks to the initial work of Dr. Sterling Baker (a person with whom I trained) and my own improvement and refinement on that work over the last decade, I now have a sophisticated, technically-challenging but effective treatment for festoons and malar mounds.
Many people don’t fully understand or recognize the differences between these two conditions. The first difference is in their cause or etiology; festoons are a result of sun-damaged skin on the lower eyelid and on the cheek and are believed to be affected by underlying contrasting muscle forces over the years of a person’s life.
In contrast, lower eyelid bags are due to age-related fat protruding through the skin in the lower eyelid region. New research has shown that fat can grow and atrophy during our lives in asymmetric ways. The growth of fat in the orbit around the eye along with atrophy of fat in the facial regions around the eye, as well as weakness in some of the orbital containing structures, contribute the fullness we see in the lower eyelid with age.
For some individuals, this fat shows up at a very young age and this is believed to a result of genetic changes in the development of the eye area in those individuals.
The second difference is the location on the face where they form. Lower eyelid festoons can be seen primarily on the cheek with some presence in the lower eyelid region.  Lower eyelid bags are located directly below the lower eyelid lashes and are noticed to become more prominent when someone with these bags looks upwards.  Conversely, festoons are minimally affected when a person looks upwards.
The third difference is the feel of these conditions when they are touched. Festoons are squishy and can be made to move side to side. Lower eyelid bags are firmer, deeper in location beneath the skin and can’t be moved easily side to side when touched.
 It is important to understand the differences between these two conditions. The best rejuvenation and most natural results occur when both eyelid bags and festoons are corrected simultaneously.
I'll include some links below.
I hope this was helpful. 

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 (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.

If you have had absolutely no fillers in your cheeks or tear trough ever, then you do have true idiopathic festoons. However any history of fillers, even 5 or 10 years ago needs to be addressed by removing with hyaluronidase to dissolve the filler. If you have never had any filler, then there are a few options available to try to improve the festoons, but none of them are that great. Surgical excision is the best option, but you don't have enough festoons to warrant trading in the festoon for a scar. Other non-invasive options:1. Doxycycline or Tetracycline injections into the tissue that's swollen. A couple of studies have shown modest improvement with this.2. RF Microneedling- recent study presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery showed modest improvement as well. I am not aware of this modality making festoons worse. If surgeons have seen this happen, they should report in  peer reviewed literature so that other providers can be made aware. Good luck. 

I think you need to back up. You need to be assessed to determine if your past fillers are contributing to your issues. The festoons can be managed with a very carefully performed hyaluronic acid filler. I can assure you that radio frequency micro needling does not reliably address your issue and can make it worse. Caution is strongly advised. While there are many excellent providers in NYC, at the same time it can also be challenging to find the right cosmetic surgeon for this. 

Festoons are difficult to treat. Morpheus8 treatments are one option that may bring improvement. They boost overall skin tone and texture by stimulating natural collagen production. We also recommend using medical grade skin care products and wearing sunscreen every day.