What is going on with my cheeks/mid-face festoons? How can I improve the appearance? (photos)

 Hi, the festoons on your cheeks are called "malar bags" and represent areas of chronic swelling trapped within the tissues of the cheeks.  Lower on the face (on the cheek bone itself) these are not associated with lower eyelid fat bags and while removing the lower eyelid bags with a blepharoplasty might make the malar bags appear more prominent...the eyelid surgery itself has no effect on the malar bags.  The malar bags occur in individuals who are genetically predetermined to have  trapped chronic tissue swelling in that area of the face.  A low salt diet is recommended to prevent the swelling from worsening.  There is no method of removing the malar bag however, the cheek and the edges of the malar bags can be augmented and softened using an off the shelf dermal filler.  
  I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Additionally, from the photos, your cheeks are quite flat anteriorly (in the front), there is excess fat in front of the cheeks and jowls are present.  These factors combine to create a rectangular shaped face. 
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Liposuction would be combined to reduce the excess fat and further shape the cheeks and face.
 When the lower face shows signs of "jowls”, these represent sagging facial tissues and are the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.