48, AA female, experiencing facial volume loss, what permanent procedures would fix all my concerns? (Photos)

It is very likely that periorbital fat grafting with micro and nano fat grafts would be solution for that area. Transconjuctival lower blepharoplasty is a good addition. Unfortunately, fat grafts do not have good take in the more mobile areas like NLF and lips in our experience; we use fillers for that purpose. Hope this helps.

For being 48 years old, I think you look pretty good.
If you’ve never had any treatments, then I recommend you consider working with fillers to get an idea of what volume representation can and cannot accomplish. When it comes to working with fillers, it is absolutely critical that you find people who have mastered this kind of work.
The majority of providers who offer filler treatments really are not very talented.
Check out the website of Dr. David Mabrie, MD. he located in San Francisco.
I’m not suggesting people come to San Francisco to get fillers, but his website has an impressive collection of before and after pictures that can help people to get a good understanding of what fillers can accomplish in the hands of the right provider.
It serves as a base liner to understand the gold standard of what can be achieved.
This can be helpful when comparing the results of other providers.
his career is focused and only doing facial fillers and he no longer does surgical procedures.
His work work is the best i’ve ever seen.
Best,
Mats Hagstrom MD