What is the best approach for these festoons? (Photo)

Festoons are prominent cheek fat pockets that swell. Treating them can be a real challenge. We have used many different treatment modalities including laser, microneedling with radiofrequency, surgery and injectables. Most of the time we need to do a combination of these treatments.In your case you have an area of relative hollowness next to your cheek fat pad. Injecting a filler that is not hydrophillic (doesn't attract water) such as Radiesse in the hollow area can help reduce the appearance of the festoon. If it is still prominent after filler injection you could proceed with an energy device such as microneedling with rf to reduce the festoon. I also recommend a low salt "clean diet" to reduce overall inflammation that can cause Festoons to well.As Festoons are notoriously difficult to treat you need to seek the help of an Board Certified Surgeon that has experience treating festoons.

First, you do not have festoons, you simply have loss fill of the malar area. This is best treated by filling the area with either fat or off the shelf fillers. It must, however, be done with the correct filler by a true expert in the area.