Lower blepharoplasty - with or without fat transfer? (photos)

Based on your description and photos, it sounds like you may benefit from a transconjunctival lower blepharoplasty, especially if the primary concern is under-eye bags or puffiness without significant skin laxity. This approach allows for fat repositioning rather than removal, which helps avoid a hollow or sunken appearance post-surgery.
Fat grafting can be a good complement to this procedure, particularly if there is noticeable volume loss in the tear trough or midface area. It creates a smoother transition between the lower eyelid and the cheek, enhancing the overall result. Since you’ve had fillers, dissolving them before surgery can provide a clearer view of the underlying structures and ensure a more accurate surgical plan. It can also be dissolved immediately before the surgery.
In addition to surgery, microneedling can improve skin texture and fine lines around the eyes post-recovery. It promotes collagen production and enhances skin quality over time, offering a more comprehensive rejuvenation.

The filler you received was not optimally placed in my opinion. You did not get treatment of the under eye circle. What you had was volume in the cheek which actually makes the under eye hollow worse. It is possible to precisely place product in the gap between the herniated lower eyelid fullness and the top of the cheek. By filling this in precisely, it is possible to address the under eye circle. Treatment is not permanent, the service last about a year or so before needing to be topped off. Eventually, the all of the filler should be removed with enzyme. This is done approximately every 4 years. The rationale is that as the old filler ages, it hold more water and does not look right. If I were treating you, I would remove all of the filler and retreat just the groove as described. It is a fussy service. Most injectors seem to be incapable of providing it. I see people from all over the world for this service.

Regarding lower eyelid surgery, be careful. When you say fat transfer that is a term that means different things to different surgeons. Generally the term "fat transfer" means harvesting fat from a donor site (usually the abdomen) and injecting it into another location. Do not do this procedure with eyelid surgery. The grafted fat is like injecting scar tissue embedded with fat. It will harm how the cheek heaps up when you smile. The procedure caused irreversible scaring in the tissue planes where it is placed. Instead you are much better off with a tranconjunctival lower eyelid arcus marginalis release. The living fat that makes the bulge in the lower eyelid is moved to the top of the cheek. This is a great procedure and eventually what you should have when you are ready for lower eyelid surgery. When that time comes, do not settle for a local surgeon. Find a highly experienced aesthetic eyelid surgeon.