I've been told I have hereditary festoons. Is this what I have and what are my options? (Photo)

This is laxity in the glide plans at the top of the cheek. This can be addressed with chemical peels, laser resurfacing, surgical excision, and in some individuals, hyaluronic acid fillers. Some individuals have a history of old fillers that has been injected to help the under eye circle. As these products age, they change in how they hold water. Removing old filler can resolve the festoon in those cases. Help is out there. Seek surgeons who have treating festoons a focus of their practice.

Yes this would fall into the category of a festoon. These are difficult to treat. Surgical options include extended lower lid blepharoplasty (tightens the orbicularis muscle) or direct excision. Sclerotherapy is another option but not offered by all physicians. Laser resurfacing and/or fillers could help hide them.
Best to see an expert in your area.

Festoons are one of the most challenging anatomic problems we deal with as surgeons since there is no perfect fix. Anyone who tells you otherwise, is either fooling your, or themselves. Fillers are an absolute no-no because of the tendency for Hyaluronic Acid to draw in fluid (hydrophilic). Radiesse can sometimes be used, but that may still cause fluids.
Options that have shown some benefit:
1. Morpheus RF microneedling
2. Laser resurfacing or deep chemical peel
3. Decreasing inflammation, especially if you have rosacea. Your photos suggests that you might. IPL is a great option
4. Injection of tetracycline of doxycycline into the swollen area
5. Accutite RF treatment (this is often combined with Morpheus RF for a synergistic effect). This would be my recommendation if you were in my practice.
Good luck

yes these are congenital swelling. lasers and plasma pen improve this. fillers can camoflage it. sometimes surgery helps but often not.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Yes, the bag you have below the lower eyelid is a festoon. The treatment of this condition is complex. There are no easy answers and there are likely only a handful of experienced surgeons who can demonstrate their expertise and show you excellent results of patients similar to yourself who they have treated. In my opinion run, don’t walk away from surgeons who suggest fillers or fat transfer to this area as treatment of your problem. Certainly, don’t see anyone but an experienced oculofacial plastic surgeon and even among these, many will not be able to help you. On the other hand, there is surgical treatments available which have proven and effective results. Good luck!

Yes, the larger of the lower eyelid bag is a festoon. A number of treatment options have been tried for festoons but here is no predictably effective surgical treatment for festoons. Some things that may help improve appearance of festoons:
Reducing skin inflammation by diet and IPL treatments (especially if there is rosacea)
Improving skin elasticity with laser resurfacing
Improving facial volume with fat grafting

It appears you do have festoons which unfortunately are difficult to treat. Some patients find improvement with lasers. Another option is Morpheus8 treatments. This can stimulate natural collagen production and improve skin tone and texture.

What you have is a variant of the ligamentous structure under the eye. In expert hands, this is easily corrected with the proper fillers placed in the correct place by an expert who understands the anatomy.