I am 39 years old with loss of facial volume, sagging cheeks and deep tear troughs, what can I do to correct this? (photos)

Hello, Happy New Year! Thank you for your question. 39 is not too young to start being proactive about your skin care and preventative options to keep you looking your best. 
With your concerns and looking at your photos, a combination treatment would address your needs best. 
For crows feet, Botox is still the most effective. By relaxing the muscle around your eyes, the wrinkles are smoothed and your eyes appear more open and alert.
For volume loss, you would be a good candidate for filler to the cheeks and laugh lines. When we consider which filler is appropriate, we look at your bone structure, your skin elasticity, and the thickness of your skin. 
At your age, to encourage DNA renewal of your skin and to keep it plump, I recommend my patients to start on a retinol product.
There are also lasers that can be directed to the dermis (strength layer of skin) to tighten and lift to a degree but this would require an in person consultation because certain skin tones cannot be treated with lasers as this will result in hyper or hypopigmentation.
May sure you consult with a qualified injector or physician who can answer your questions and give you a personalized plan to get you looking refreshed.
I hope this helps! - Dr. Leong

Your photographs show early signs of ageing, particularly in your skin texture.  I would start with topical medications for your skin first, such as Obagi or Dermesse (there are others also). I would seek the one-on-one examination and discussion you can get from a boarded plastic surgeon since a plastic surgeon can treat you non surgically as well as surgically if the latter is indicated.  

I'd recommend starting with replacing the volume that is naturally lost as we age in the cheek area with a filler such as Voluma.  You will want to be sure to find someone who has master injector experience and can give you a lift while they are injecting to replace your cheek volume.  It will help all of your complaints discretely by making you look more youthful, helping crow's feet, and improving the deepened tear troughs.  It also lifts the drooping at the nasolabial folds and marionette lines around the mouth if done correctly.  That is not to say that you may not need more filler there and botox for the Crow's feet, but I would start there, as that volume loss contributes to most issues and replacing it really makes an amazing improvement, which patients typically love.

I think combination treatments work best when it comes to antiaging. In your case, a filler such as Restylane Lyft or Sculptra could be injected into the midface to correct age related volume loss and to lift the face. Newer generation flexible gel hyaluronic acid fillers like Restylane Refyne and Restylane Defyne could then be injected into the laugh lines. Wrinkle relaxers like Botox or Dysport could help with the lines around the eyes. Skin tightening with the new Thermage FLX and skin surfacing with Clear + Brilliant combined with a good at home skincare regimen would round out the results. 

The best thing you can do that will address the problem easily, quickly , safely with no downtime is the use of fillers. Other options are fat transfer. Combination treatments including, vampire facelift, j/plasma or RF for skin tightening , Botox for crows feet might help.

Non-surgical options include a liquid facelift which involves a combination of fillers and full face Botox/Dysport. The instant fillers that work well are from the Restylane and Juvederm family and often 4 or more syringes may be required for an initial treatment. Of course, after discussion, some patients prefer Sculptra first as a foundational skin treatment as it tends to help patients who desire full face recontouring and revolumizing. Last, skin care systems such as Obagi Nu-derm help with collagen stimulation, brightness, and texture/tone - which are important traits to improve in anti-aging of the skin. I would advise getting a consultation to learn more.

The changes in your face are fairly typical of women in their late thirties and to restore a more youthful appearance usually requires a combination of conservative treatments which include medicated skin care products and treatments to restore more youthful and even looking skin, Botox for the crows feet, and judicious use of fillers which may include fat grafting techniques such as nanofat. It is important to get a comprehensive evaluation and treatment plan that not only includes initial treatment objectives, but then also an ongoing maintenance plan.

Great question! You have 3 categories of options. #1. Non invasive options - Silhouette InstaLift, PDO threading, Y Lift (the one I would choose if this was the option for you or a combination of all those), peels, superficial HA fillers, Botx. #2. Minimally Invasive option - a mini Face/Neck lift, 1-stitch FaceLift with option #1. #3. Invasive - a full Face/Neck Lift, SMAS. So best to seek a few n person consultations with boarded surgeons in your area.