Are there procedures that would address my cheek and eye wrinkles or should I consider a facelift? 55 y/o (photos)

Living a healthy and active life and receiving regular botulinum toxin treatments have likely helped slow down the visible signs of aging on your face. However, as we age, structural changes in the face — including skin laxity, fat redistribution, and weakening of connective tissues — become more noticeable. These changes often result in deeper lines in the cheeks and around the eyes, as well as sagging that pulls the facial features downward.
Dermal fillers can provide support and soften some wrinkles by restoring volume, especially in the midface. But in cases of moderate to severe sagging, fillers may fall short and can even distort facial proportions if overused.
Laser treatments and energy-based devices like fractional lasers or radiofrequency microneedling (e.g., Morpheus8) can improve skin texture and stimulate collagen, which helps with fine lines — but their lifting effect is modest, especially when deeper tissues are involved.
At this stage, a facelift may offer the most natural and long-lasting improvement. Modern facelift techniques do more than just tighten the skin; they reposition deeper structures like the SMAS layer, restoring youthful facial contours without looking overdone. In your case, especially given the combination of volume loss and tissue laxity, a facelift — possibly combined with eyelid or neck rejuvenation — might provide a more balanced and comprehensive outcome.
Every face ages differently, and the ideal solution is always personalized. But when nonsurgical options are no longer enough, a well-performed facelift becomes a rational next step, not a last resort.

A deep plane lift would lift the deep tissues in your cheeks and lower face with a natural and long term results. It will significantly reduce these lines when you smile.

These wrinkles are dynamic and will not improve significantly with facelift alone. In an ideal world you should get a facelift and laser resurfacing. If you don't want surgery then a combination of fillers and laser resurfacing will help.
Regards
Dr. J

Thank you for your query. Fillers and laser treatments can certainly help but will not give you the kind of improvement that you may be looking for. A lower blepharoplasty and face lift with some autologous fat grafting is probably the best option for you. Laser resurfacing can be done at the same time or later for further improvement .Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Botox does help reduce crow's feet, but after you've been doing this a while and getting older, it is time for the next step. Laser resurfacing using a CO2 laser (I use an Ultrapulse) works best. Of course, a facelift is a good option in a 55-year-old woman as well and many patients do the procedures together. Fillers would not be particularly helpful for these wrinkles.

You would benefit from a face and brow lift. The brow lift will lower the hairline, remove the wrinkles from the forehead and raise the eyebrows slightly. The face lift would pull the lateral cantho area more laterally, take care of the wrinkles and pull up neck and face.

Best Wishes,

Gary Horndeski, M.D.

While a few of the pics you submitted suggests that you might benefit from a facelift (particularly in the lower face and the neck), your major areas of concern is the wrinkles in the cheeks and lower eyelids and these areas would likely not respond to this surgery. While you could try neuromodulators other than Botox, I think that your best chances of achieving significant long term improvement in these areas would be with a combination of midface lifting with festoon repair and a full face Hetter Peel procedure.
You could probably find before and after photos of patients with these concerns I treated with these techniques. Good luck!

The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove any fat deposits in the neck, which also includes a platysma plasty to significantly improve the jawline. For dynamic crows feet, Botox or one of the neuromodulators would be that your best solution for that problem. Performing a facelift for the crows feet will only have minimal, if any improvement. Laser treatment treatments would also have some benefit as well on that area.

Based on your nicely posted, photos would recommend virtual consultation and consultation for by which options for surgery would be a mini face necklace with muscle tightening, and lays laser therapy, Botox to crows feet and cheeks, nano rafting, fee $12,000-$20,000. Best of virtual consult with.