Which procedure would be best for addressing skin folds around my eyes? (photo)

The infraorbital tear troughs and hollows indicated in the photo are quite common problems treated just about every day in active cosmetic dermatology practice. There is a suggestion here of volume deficit in the upper cheek (ogee) region, and since the upper cheeks are such an important for the support for the under-eye area, simply revolumzing the cheeks with a robust HA volumizing filler would likely not only create a more oval, feminine, heart-shaped face, but secondarily improve the under-eye hollows and tear troughs. A low viscosity, cohesive, malleable HA filler may then be used if additional treatment is needed for further improving the infraorbital region. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Be sure to ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

A lower blepharoplasty, assuming you have no contraindications to such a procedure, would likely b a great option. Filling the tear trough with dermal fillers (HA fillers) could be an alternative although from the photos the former is probably more suitable.

Best wishes,
Thomas Walker, MD, FACS
470-900-3223

To accurately give you options a physical exam is necessary. Have you had your lower eyelids done?
The photos suggest that your cheek is descending. The operation I prefer is a subperiosteal cheek lift. This operation involves the entire cheek to be mobilized and lifted vertically. This will reposition your cheek fat up to the bony orbital rim. Fat transfer into the cheek can further enhance that area.

The area of concern is highly complex and simply understanding what the problem is by itself can be a lengthy conversation.
Your picture really does not depict what your actual concern is.
Is it the medial canthal webbing or loss of volume in tear trough?
I suggest having a few in person, consultations with oculoplastic surgeons in your community.
Best,
Mats Hagstrom, MD

You have some hollowing of the junction between the eyelids and the cheek, which is very common. Treatment would consist of a soft tissue filler versus fat grafting of the cheeks to offer support of the lower eyelid. I would caution that some patients who have the tendency to have allergic eyelid swelling or puffiness may experience reactions to the fillers that can cause prolonged swelling or a bluish hue. Something to consider when weighing your options.