Around the eyes or periorbital region filler vs fat injections results in depend on understanding both perioral anatomy and perceived sign of aging. Volume augmentation can be beneficial for treating deep nasojugal lines (often referred to as "tear trough" defects), the elevation of the temporal brow, and even smoothing fine eyelid wrinkling. It is also an excellent choice for correcting static wrinkles that it cannot treat with BoNT alone and re-contour. Which filler substance is considered "best" or "preferred" for you depends on the doctor's technique, skill, experience, training, facial needs, and risk tolerance? It has nothing to do with headlines in the media; these are often a result of its marketing. While synthetic fillers can smooth out wrinkles and folds, they cannot restore fullness that is naturally lost as fat and bone diminish, and it is not for everyone. Some individuals are allergic to synthetic materials and may develop an allergic reaction. Nevertheless, its use stays limited compared to commercial fillers. It appears that surgically trained and oriented cosmetic practitioners are far more likely to use fat. In large numbers, less surgically dermatologists, non-surgically trained "cosmetic practitioners," and non-physician "extenders" such as physician assistants, nurse practitioners, and even simple registered nurses favor synthetic fillers over autologous permanent fat filling injections.