Rather than choosing a procedure, I prefer to first start by trying to understand the problem. If the problem can be corrected with a surgical solution, then somebody may be a good candidate for surgical intervention. Generally the first step is to make a diagnosis a.k.a. assessment. I generally recommend patients to do this by having multiple in person, consultations foot plastic surgeons in their community. If we are going to make assessments using pictures, then we need to see standard facial pictures without facial expression. We generally don’t treat people based on what they look like when they contract muscles of facial expression. The exception is with the use of Botox. Take a look at how plastic surgeons take before and after pictures to get an idea. The procedures you describe treat totally different things. Fat transferred to the temples. Tends to not work very well and I generally am not a big fan of facial fat transfer in the first place. Facial fat transfer tends to be unpredictable, imprecise, and potentially unforgiving if patients don’t like the outcome. This is especially true if you compared to volume augmentation using fillers. Jumping in to scheduling surgery needs to be done carefully with a well thought through plan, which always starts with having a clear understanding of what the underlying problem is. Consult with plastic surgeons in your community and see what they have to say. I see no obvious need for surgical intervention based on the pictures you’ve included. Best, Mats Hagstrom, MD.