Thank you for your question. You submitted a single photo with an arrow pointed to your area of concern. You state the under eye correction you had with filler is unequal, and your doctor is unable to fix it, so you’re looking for guidance on what to do. I can share with you my approach to patients like yourself, without the benefit of other views and a physical examination. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people with the under eye area from puffiness, hollows, and facial aesthetics with both non-surgical and surgical solutions are a big foundation of my practice for more than 2 decades. I’ll share with you first how I counsel my patients when I evaluate them for rejuvenation in this area. To begin with, I take photos, from the front, 3 quarters views and side views and help patients understand that when they look in the mirror and they see a hollow under the eye, well very often, it’s also in the context of the face also having relative asymmetries in terms of the relative prominence and projection of the cheekbones. And that’s a very important factor. Because when I look at someone, when I look at the eyes, I just don’t look at the eyes. I look at the eye as they relate to the cheek area and this can be very helpful in planning a strategy that can optimize the rejuvenation. When I look at your face and the area you point the arrow where you’re concerned about the asymmetry and the indentation, I notice the cheek area and the eyelid to cheek junction has less volume in the most prominent part of the cheek called the malar eminence. I help educate my patients about this because when you use a filler like Restylane in the tear trough which works extremely well, if there is no support in cheek volume, it’s like sitting on a ledge, so you can have these elevations, and relative indentations. What I frequently do is combine the filler under the eye with a filler on the cheeks, looking at the eye and cheek as one continuous area. We use a method called Structural Volumizing for the cheek area which is important because we’re trying to correct the volume at the bone level. It’s also important to correct volume at the deeper fatty compartments of the cheek as well. This way it looks more natural, blends without creating surface irregularities, and does not look overdone, which is the art of doing this. That’s a suggestion for you to explore, not to necessarily just keep adding volume along this rim, but to also consider augmentation in that cheek area to balance out with the other side. There is nobody who has a perfectly symmetric face, so what I explain to my patients is we’re beautifully imperfect. However, it’s understandable if there’s an obvious difference that’s drawing the attention of people around you, but that’s not productive, so you want to do something about that. If your doctor is unable to assist you, find a cosmetic surgeon who knows this area very well, and does a lot of fillers at the under eye and cheek areas. With technique, there are many different ways to use these injectable fillers. The way I do these procedures with blunt cannulas and my understanding of anatomy as a surgeon has given me a certain perspective that’s different from someone who hasn’t operated in this space, from people who treat at a more superficial level, not naming specific specialties. I certainly feel, from my perspective as a surgeon, that Structural Volumizing and these compartments around the eyes, has been definitely successful with this. I think that is a key to helping you maximize the symmetry you’re seeking. Meet with qualified, experienced doctors in this area and learn about your options. I think you should be able to get an improvement. You may need to dissolve a little filler, but I don’t think it would be necessary. The key is to have as good of a balance as possible. The take home message here i, understand how the eyelid and cheek are really connected, and how enhancement can create a more balanced appearance. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.