Under eyes look terrible after facelift - what can I do to fix this problem? (photos)

Greetings Margaret Elaine:Your concern here is very evident based on the photos. Without full face photos visible it is not easy to say whether or not the facelift contributed to the appearance but I doubt it. The power of most facelifts lies in improving jowls and neck bands. That being said, certain facelifts are better at improving the midface and lower lid area: the extended deep plane facelift releases the (zygomaticofacial) ligaments that limit upward mobility of lower facial tissue into the midface. By recruiting volume to the midface and lower eyelids, the extended deep plane typically does a better job or improving the aesthetic of the lower eyelid-midface continuum.
With that being said, you have 3 main issues contributing to your complaint on lower eyelid appearance: 1) Skin quality issue with wrinkles in the native eyelid skin, this is very common2) Upper and lateral cheek volume deficiency3) Festoons aka secondary lower eyelid bags that are related to the anatomy of the ligaments in the midface. These are challenging to treat.
In my experience, here are are the most effective things that could be done to improve your issues while maintaining safety and a natural look:1) Lower eyelid blepharoplasty with some component of skin excision, I prefer the skin pinch2) Skin resurfacing, most effective with a laser given the depth of the wrinkles3) Volume replacement, my preferred source is your own fat.
You will be in the best of hands if you choose an eyelid specialist for the above. Some facelift surgeons are great at eyelids and some are not. Given the response of your facelift surgeon, you may want to seek an opinion form an Oculofacial Plastic Surgery Specialist here. You can find one in your area at the ASOPRS website.
Best,
DBS

Based on your very cropped photographs it looks like the problem is with your lower eyelids and not the face. Often, surgery to fix one thing can make another problem more evident, but, this one is an easy - in the office fix for the most part.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.