What are these dents under my eyes, on my inner cheeks? How can I fix them when filler hasn't?

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Hello,You have tear-troughs.  Tear-troughs are primarily a bone shape issue and secondarily a soft-tissue problem.  Tear-Trough implants are an excellent way to effectively produce a change to the shape of the bone.  They are permanent (but removable).  They look and feel like normal, you can not move them or tell they are there (except when comparing to pre-op photos).  Soft tissue fillers can help, but not nearly so much as an implant.  If you are going to continue using injections, only inject hyaluronic acid products (Restylane/Juvederm) in that part of the face.  Products such as Sculptra should never be used there.  Fat transfer may also be helpful, but is inconsistent and will change significantly with weight gain/loss.  Fat will also change with age and is not readily removable.  The implant will be consistent for the rest of your life, maintaining good shape even as your skin and soft tissues age over the top of it.  Regards,Dr. A  

Based on these photos alone, it is unclear to me if you are a good candidate for tear trough filler treatment. I see some swelling under the eyes which suggest you may not be. Filler injection to the anteromedial cheeks may help with your concerns. The best thing to do is schedule an in person consultation with an experienced aesthetic physician to determine an appropriate treatment plan for your cosmetic concerns. 

Hello. It looks like your fat pad is separating. This is normal with aging. Filler can temporarily fill it, but it will dissolve over time. You could try Sculptra in the area for longer results. 

In my opinion tear troughs are best treated with autologous fat grafting. Find yourself a plastic surgeon who is well-versed with fat grafting techniques. I hope this helps and good luck from New York City