What can I do to fix my deep set or tear trough under eyes? It makes me look older (Photo)

Deep set tear troughs are very challenging to improve -- especially based on your particular anatomy. Many questions on this forum are answered quickly by many doctors - im not surprised that not a single other doctor has responded yet to your question. In 2017 we still have no perfect solution for this challenging problem. Tear trough or cheek implants were once tried but they look unnatural and have other problems and have been mostly abandoned. Blepharoplasty can not help you. Filler in the tear trough can be tried, but from your photos I think this would be difficult to achieve a natural, normal looking result -- but you could consider filler such as Restylane. Fat transfer is not something I perform and certainly does not last long in the tear trough at all -- but this could be considered, just not with me. I am sorry I cannot offer a better answer. Best wishes. Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

you are a perfect candidate for fillers in the tear trough area.  Several fillers are available and you experienced Dr should be able to choose the right one for your need.  The filler should raise the depressed area and give a rested and younger look.  Make sure a board certified Dr is doing the injection.