Hello there, It appears that you have some mid-face descent with prolapse of the inferior orbital fat pads. There is loss of volume in the mid-face area. I think you have a two options - non-surgical and surgical: Non-surgical: Filler placement along the tear trough and over the malar eminence. This will give you more volume and potentially 'mask' the bag type appearance you have from the prolapsed fat pads. Surgical: A lower eyelid blepharoplasty may also help. It is important to realise though that simply removing the fat may give your lower eyelid a more hollow appearance. Therefore fat transposition of the prolapsed fat into the tear trough and over the lid-cheek junction may be better. At the same time your lower eyelid should be secured as there appears to already be some retraction and this may worsen from surgery. You can also consider a combination of the above treatments. Discuss the various options with your surgeon and be comfortable with the risks, alternatives and benefits before proceeding.
