What procedure is recommended for my deep tear troughs, hollow sunken eyes and malar bags? (photos)

I have never bought into the notion of the tear trough. Many patients get themselves talked into fat transfer for this. I’ve never seen a good result but I’ve seen plenty of patients develop lumps in their lower lids. In your case removal of the excess fat is what is needed, although it is really not even that bad in your case.

Based on your photos, it appears you would be a good candidate for tear trough fillers. This nonsurgical treatment places small amounts of dermal filler into the area under the eye, adding subtle fullness and reducing discoloration. I typically perform this procedure using a blunt-tipped micro-cannula to ensure the smoothest result and reduce the risk of side effects like bruising and swelling. Make sure the injector you choose has the experience, training, and expertise to provide you with the most natural results.

You appear to be relatively young and therefore have maintained a decent amount of volume in the cheeks and mid face area. If this is the case then a single syringe of Restylane should be enough to address the problem. If there is also medial cheek deficiency then another syringe of perhaps Juvederm Voluma, Radiesse, or Restylane Lyft will help support the lower eyelid at the lid cheek junction when placed appropriately.