That really depends on the patient’s ultimate goals, finances, and ability to tolerate downtime. For patients with limited finances and the inability to tolerate any downtime, I would recommend the hyaluronic acid fillers as they are instant in their gratification, they are relatively low cost, and come with virtually no downtime. Their only disadvantage is that they are temporary, but around the eyes, they typically last close to one year. In the lips, however, they tend to resorb within approximately a six-month period and would need to be reapplied. Fat transfer, on the other hand, is quite successful in the under eye area when performed by experienced facial plastic surgeons. There certainly is a great risk of creating irregularities and bumpiness in the lower eyelids with fat transfer and that is why I stress the importance of an experienced injector. Regarding the lips, I actually prefer using hyaluronic acid fillers as I can then do a very artistic augmentation, which will provide the patient with extremely natural results and though it is not a permanent fix, it is very consistent in my hands. Fat transfer, on the other hand, I feel has some inconsistencies with it in that some areas of fat will resorb while others will survive and lumpiness is not uncommon when injecting fat into the lips. I therefore only inject relatively small quantities of fat into the lip so that these irregularities can be minimized. Overall, both of these alternatives are extremely good at treating the under eye hollows and for lip augmentation and it really depends on the patient’s desires as to which procedure I would therefore recommend.