24F. What is the best course of treatment for these lines that drag my face down? (photos)

A transconjunctival blepharoplasty to remove the medial fat pad that ads lower lid fullness would be ideal to correct this fold.

Of course, there is no substitute for an in-person examination that allows for not only a closer, more three-dimensional assessment, but for palpation and manipulation of the tissues. From the photos provided, however, it would appear that an HA Filler Cheek augmentation would address the flattening of the cheeks, the lack of smooth transition between the upper cheeks and the under eyes, and the deepening of the smile folds, The overall result would be a more feminine, heart-shaped face. In addition, a couple of microdroplets of Botox would likely diminish the prominent under-eye "jelly rolls." You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector. Hope this helps and best of luck.

Believe it or not, a large part of your issue is due to a lack of cheek volume that is causing the facial skin to lack support. Filler into the tear troughs and cheek areas will help a lot and it will take minutes.

From your photos it appears you would have improvement with filler. This can be placed under the eye and in the cheek to help improve facial contours and the transition from one area to the next. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

A very conservative lower blepharoplasty performed through a trans- conjunctival approach in the inside of lower lid can accomplish removing the herniated fat bags in your lower lids.