Take heart. In experienced hands, one treatment session using an appropriate volumizing filler for the cheeks would likely both significantly improve the cheek flattening apparent in the photo and improve the under eye tear troughs. It's been dubbed the "domino effect" by my European colleagues because treating one location of the face with filler can have a domino-like improvement in adjacent areas, in this case treating the cheek improves not only the cheek, but results in the smile lines, as well, and lends support to the under eye area leading to improvement in the hollows and the tear troughs. Other approaches that might be offered to you are surgery or fat transfer. However, surgical lifts are expensive, aggressive and invasive and engender real downtime. And fat transfer, which I gave up performing several years back carries with it several drawbacks. For one one, most of the fat, separated from the donor sites of the belly, buttocks or thighs, does not survive once separated from its original blood supply. Moreover, it is a relatively expensive, two step minimally invasive process that entails large cannula withdrawal of the donor fat and large cannula transfer into the recipient locations--all of which means real downtime. And finally, any fat that does survive retains the characteristics of the location from which it is taken meaning that if belly fat develops a midriff bulge with aging, so, too, can the belly fat transferred into the face. Make sure that you consult with a board certified cosmetic dermatologist and ask to see his/her personal before and after photos before agreeing to proceed. and best of luck.