What is causing these dimples under my eyes? Aging? Migrating filler? (Photo)

Hi! The under-eye area is made up of hills and valleys. Both of these combined cause the dimples or depressions you see. The valleys are caused by both volume loss, ligaments, as well as accentuated hills. The hills can either be orbital fat herniation as well as filler. To determine this a clinical exam is necessary and possibly an ultrasound. If it is filler, dissolving the filler is one possible solution. An under-eye blepharoplasty would fix the fat herniation and smooth the lid cheek junction. While fillers only last a year or two, a lower lid blepharoplasty is a more permanent solution. Hope this helps!

Good morning! Thank you for your question. I understand your frustration with these pesky divots, as I happen to have them myself. These can come up after filler is injected in the area, if the zygomatic cutaneous ligament is disturbed, or they can simply be seen with aging. It is hard to say what the case is with you, unless you feel they came up shortly after getting filler. Either way, they can be a bit challenging to correct.
If a patient has had filler injected in the under eye/mid cheek area, and this is a concern, I recommend dissolving any potential filler in the area first. If the issue is remedied then we know the divots were due to the filler. If not, then I would use a very soft and flexible filler, like Restylane Refyne, to fill the divots, in an effort to camouflage them when you smile. It is important to be conservative and choose your product wisely for this particular area, because it needs to look good at rest, and at animation. Having appropriate expectations is also key here. Know that they may not be completely erased, but rather softened after treatment.
I hope this information helps and wish you the best of luck.