What do I need to treat a negative orbital vector and tear troughs? (Photo)

Good Afternoon! A negative vector can be a challenge. The options would include fat or filler to the tear trough and anterior orbital rim areas in addition to cheek implants. Augmenting the cheek can correct the vector and will help to improve the appearance. Cheek implants can be made of silicone or MedPor for example and come in various shapes and sizes. You could try filler at the cheeks though the volumes may be significant as would the upkeep. Seek a consultation with a facial plastic surgeon to learn more about what may be your best option. Hope this helps.