What are my best options for festoon removal? (Photo)

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question. I think that you have festoons, or malar mounds, or malar bags, and this is a significant and highly distressing problem. The treatment of festoons is quite complex. I believe that treating this condition is solely in the purview of an oculofacial plastic surgeon well versed and experienced in treating this condition. Avoid general plastic and facial plastic surgeons, the best of whom would or should decline to treat you, in my opinion, as they simply do not have the necessary background knowledge in the anatomy and in the pathophysiology most likely causing the problem. Without doubt, I would avoid further fillers to your cheeks and tear troughs and would avoid fat transfer too (even though this was recommended by a general plastic surgeon who also answered your question). First, you should dissolve, perhaps several times, any fillers you have had, no matter how long ago you had them, with hyaluronidase. After this, you could consider radiofrequency microneedling or ablative laser treatments. Personally, I have had much success treating this with surgery (have a look at the real patients, many of whom travel to me from other states, I have treated on my website), but as with any surgery, there is never a guarantee. Feel free to contact my office with questions. Good luck!