Should I do tear trough filler or lower blepharoplasty? (Photo)

Thank you for sharing your question and posting your photos. Part of the issue is the prominence of the purple blood vessels under your skin. Unfortunately, there is no treatment for this problem other than cover up. The puffiness can be improved with surgery, but it does appear that you could benefit from fillers. Make sure to have either procedure performed by an experienced oculoplastic surgeon. Good luck!

In my opinion, a tear trough filler or a lower blepharoplasty could help improve the issue with the bags under your eyes. The surgery would give a much longer lasting and potentially permanent result, while the filler would be temporary. The lower blepharoplasty would improve the issue by addressing the protruding fat directly. Using a filler helps to camouflage the bags by injecting underneath them to blend them into the face.

Hello. Your lower eyelid fat pads herniate, which is made more obvious by having prominent eyes. A filler can only cause more problems. You might benefit from a combination of eyelid fat debulking and repositioning, +/- midface lift to smoothen the eyelid/cheek transition.