What should I do first, tear trough or cheek fillers? (Photo)

It's hard to give you complete recommendations without examining you in person and with the limited photo.  But I generally recommend starting treatment in the areas of the face that are most hollow or with the greatest loss of natural volume.  These are the areas that make us look most tired or older.  Then over time I would expand the areas of injection to the rest of the face.  In your case, the areas under the eyes are relatively hollow so that seems like a reasonable place to start.  after a careful examination, your doctor can decide which product is ideal and whether other areas need injection.

I like to treat the cheeks first, see what effect it has on the tear troughs and then inject the tear troughs if necessary, perhaps with a different filler.  Both areas can be treated at the same visit. Which filler to use is not as important as having treatment with an experienced physician injector who will use their favorite products.

I would do both if your budget would allow it. I dont know how old you are, and dont have a side view.If you are middle aged and lost cheek fullness on the side view the combination of Juvederm in the tear trough and Voluma in the cheek would camouflage this the best. A younger patient just Juvederm, Boletero or Restylane in the tear trough would improve.Several years ago, just treating the tear trough alone was what we did, but not helping the upper cheek with another filler is more common.Another option is transbleph surgery and moving the fat across the trough. The appearance is caused the muscle attachment to the orbit.A consultation is necessary to make the final recommendations whether to do one or both