Malar Creases. Need advice. Fillers didn't work. What now? (photos)

You have early stage festoons. Fillers and fat grafting are often recommended but rarely successful. Some surgeons treat it with aggressive laser resurfacing, which would not be appropriate for your skin type. I've treated them successfully with excision, which I also would not recommend for your skin type. In short, I don't think there are many good solutions for your problem. I would be careful of injectable treatments that lack evidence of efficacy.  Make sure that the surgeon you choose actually has experience with your skin type. Good luck!

A combination approach will give the most improvement. Fillers combined with lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

In order to correct the malar crease, the right kind and amount of filler has to be used . The filler would need to be placed in the deep malar supraperiosteal area. It is likely  ( looking at your picture) that the amount was not enough to inflate the affected area. The malar crease is a result of deflation  of the malar fat fad.
Ladie Arana-Domondon, MD FACP

It is normal and natural to have a nasolabial fold and creases. However, you can probably still soften them by receiving filler in your cheek area (volume may be a good option). Hope this helps.

I would recommend HA filler such as volume or juvederm ultra plus combined with platelet rich plasma vs fat transfer or sculptra or combination of these treatments 

We have actually had luck with Infini RF treatment in this area. There is not much downtime and it has helped improve this problem in several patients in our practice. 

Midface Rejuvenation can start with bringing back fullness to the Malar/Cheek regions.Fat transfer with prp is a good option because you can achieve full correction in just one treatment.Choose an expert. Best. Dr Brecht Seattle, Wa