Often times, patients present with flattening in their infraorbital area where the anterior aspect of their cheek is located. This makes the hollowing under the eyes more pronounced. Prior to doing anything in the tear trough area, the malar cheek area must have proper support with filler. We typically use Juvederm Ultra Plus or Juvederm Voluma in the malar area which helps to fill in the infraorbital hollowing. If the tear trough still needs filling after proper support has been restored to the malar area, then we add either Juvederm Volbella or Belotero at a follow up appointment.