What is the best nonsurgical treatment for malar bags.
Thank you for your question. Surgery is not the answer for malar bags.
Acceptable cosmetic results can be achieved with injection of the dermal filler called Restylane.
You could try fillers. I think in the first instance I would use a temporary filler - i.e. hyaluronic acid. You could see the effect and if you liked it you could have a discussion regarding using it long term vs the use of autologous fat transfer. I would have concerns that going straight for autologous fat which is often permanent may not be the look you wish to achieve.
Correcting Under Eye Hollow
What you have is common from loss of fill under the eyes. It can be corrected with a filler that is strong enough to elevate the cheek in that area. The best two off the shelf products are Juvederm Voluma and Radiesse. Both a last about 1.5 years. However, at your age, even this is not enough. I would, therefore, suggest fat. Once you have achieved a complete correction, it is generally permanent.
In reviewing your pictures, I do not believe you have malar bags. Malar bags are a collection of fluid on the upper cheek area. Malar bags will tend to change in size as the area becomes more/less swollen.
Your pictures show a small depression or groove in the cheek area. This area can be easily correctly by a qualified injector a filler. I would recommend using a reversible filler the first time such as Resylane, Juvederm, or Perlane. In my practice, you would be an excellent candidate for filler.
I hope this helps.
This is not a malar festoon or malar crescent.
This is your mid-cheek groove. Filler in the form of Perlane or Restylane can provide excellent filling for this groove. The treatment is office based, comfortable, and the service can last over a year. Look for a very experienced injector to help you with this.
Mild degrees of malar bags and eyelid bulging are commonly and reliably treated with injectable fillers (Restylane) or fat injections.
The fat may also be addressed using fat dissolution injections.
Please consult with a Board Certified Plastic Surgeon in person prior to making treatment decisions, cheers.