What is the best treatment for malar mounds/festoons? (Photo)

At your young age, consider doing nothing. Surgery may be an option as you age, and fillers would not likely help, and possibly accentuate the fullness. I have not seen laser as an effective modality. Please don't distress. Dr Joseph 

Hi @cmp08011. Thank you for sharing your photos. I recommend Morpheus 8. Morpheus 8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin
tightening and lifting.

Best of luck,

Dr. Nima

Thank you for sharing your excellent question and photographs. These are difficult to treat as no reliable treatment exists.  Best options at seeking improvement would include RF and superficial dermal filler placement by a specialist.  Best wishes!

This is a very difficult area to treat, and fillers can often make things look worse and unnatural. We have had good success treating this area with radiofrequency microneedling (Infini) in our practice. Best of luck.Emile Brown, MDBoard Certified Plastic Surgeon, Johns Hopkins & Harvard Trained

In older patients, I recommend excision of malar mounds. In your case, you may experience some benefit from non-invasive modalities like RF treatments. I definitely do not recommend any filler treatment because that could make it look worse. I recommend consultation with a plastic surgeon to learn more about these different options.
Hope this helps.

Thank you for your inquiry.  This is a difficult area to treat.  Given your apparent young age I would caution you about doing anything too drastic.  We have have very nice results with using a  dermal filler and skin tightening with the Lutronic Infini.  Make sure you consult with an experienced injector as placing dermal filler in this area can accentuate the problem if not done correctly.

I do have success with RF microneedling - Infini or Genius. I'll be starting a study for this problem using the Genius. I also treat with superficial injections in dermis to camouflage this area, just below the mound. I don't believe that fat grafting is a magic solution for this and I would discourage this. It is irreversible and takes months to settle down. You might have swelling for weeks/months with fat grafting and might even need further grafting to get it right. I don't think volume is the answer except for 0.1-0.15cc of Refyne each side.

In my opinion, patients with firm cheeks, do not need high density filler under the skin. If patients loose middle fat pad volume than more hyaluronic asid gel is needed. 
In your case, there are good solutions with juvaderm volite or restylane  skinboosters vital/vital light. I have been using it a lot and my patients are very satisfied. (19 years experience)
The most important is to perform injection in the precise LEVEL.
If it will be injected to superficial it may create waves on the skin. If it will be to deep it will make no effect at all. 
Try to find a doctor who understands your needs and whose esthetic vision fits yours.
Most important, try to find one esthetic doctor who can use filler like sculptress use clay.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Good Luck.
Dr. Devrim Elmas, MD
Medical Esthetic Doctor
IG: @drdevrimelmas

These lines are common and I think that they are more of a genetic trait then a sign of aging. I call them "goggle dents" because looks like you were wearing goggles.  I have these myself and have found that a combination of a thicker filler like Radiesse or Restylane Lyft , often with a softer filler more superficially, does improve this considerably in most people. Just be sure that the person doing this is very experienced and has worked with this before. 

I would definitely discourage you from using fillers in this area as they almost never result in something positive. Autologous fat grafting will work extremely well in this area and may help you get rid of it once and for all. Good luck from New York City