Do I need cheek filler or under eye filler? (Photo)

Thank you for sharing your question and posting your photos. You would require one syringe of filler under your eyes to treat the darkness. Restylane is the best choice for this area. Find an expert in the slightly more risky area.
Good luck,

In the first photograph, you appear to have herniated orbital fat that is significant. These can sometimes be filled around. However the ability to do that depends on many factors. I suspect that you may be a better candidate for lower eyelid surgery with a chemical peel. I do have patients who will do filler because they really want to avoid surgery. The ability to accomplish this will very much depend on the volume needed to fill in the groove under the bags. This is a fussy service. The type of filler offered makes a big difference in the success of the service. Many injectors will place runny fillers for this. That is a mistake. The best filler for this type of service is Restylane. It has one of the highest G primes of all the hyaluronic acid fillers. However it needs to be very carefully sculpted in place. If you are a candidate for filler, you may need 1, 2, or 3 milliliters of filler depending on whether you are looking for the circles to be improved or essentially eliminated. Again, there is no substitute for a detailed in person assessment.

From your photo you appear to be a candidate for a lower blepharoplasty. This is a surgical approach to improve the bags under the eyes. Other options would include fillers to both the eye and cheek area to improve contours. Another option is AccuTite which is a minimally invasive procedure that can target precise areas to tighten skin and melt fat. See a board certified plastic surgeon near you for an evaluation to learn more.

Thank you for sharing your photo.
There are two ways to look at your options: Surgical vs non surgicalIdeally, surgery will help remove the bags permanently while dermal fillers will provide instant but temporary improvement.Your case is not easy. I advise you seek both options for consultation and then decide which route to proceed. Generally, it is not bad to start with non surgical option with HA fillers to see how refreshed you will look and then get surgery later. There are also different costs between the two.You will need both cheek and under eye fillers for best results. Likely starting between 3-4 ml of fillers first and then assessing for further additional filler if needed. It is best to start slow.Another important factor to consider is seasonal allergies, if you suffer from seasonal allergies , it is best to avoid dermal fillers around the eye area.Hope this helps.Best, Dr. Anna Avaliani, NYC

You’re still quite young where the skin in the lower eyelid is quite tight and it is for those reasons that I would recommend that you have a transconjuctival blepharoplasty. This way you will not have any external incisions. At the same time I would like to urge you to stay away from fillers, and instead consider having fat grafting for the flatness of the cheeks or the face. Fat grafting when done by an expert Plastic surgeon should produce natural and permanent results. I hope this helps in. Good luck from New York City Plastic Surgery.