Hello and thank you for your question. From what I can tell based on the pictures you have provided, going top down, you have some prominent wrinkles in your forehead and it appears there might be some brow ptosis. Regarding your eyes- there is some significant upper eyelid skin redundancy on both sides. I see some prominence of your tear troughs but not really any lower eyelid bulging ("bags under eyes"). Based on this, I would recommend a browlift and upper eyelid blepharoplasty. Moving to your mid/lower face and neck- there is some minimal/moderate jowling, prominent nasolabial folds, downturned mouth corners. This occurs with age as the soft tissues of the face start to descend and as we lose volume from fat atrophy and bone loss, resulting in the characteristic changes of facial aging. You also have excess neck skin. I cannot tell if there is any platysmal banding in your neck. I would recommend a facelift/necklift, as this would be the best way to address the soft tissue descent and jowls to improve jaw definition and restore a more youthful appearing face and neck. It would also help remove some of the excess lower face and neck skin which is contributing to all the wrinkles. At the same time, facial fat grafting can also be done to address volume loss and help further improve facial balance and harmony. I would particularly focus on grafting to the cheeks to soften the lower eyelid/cheek transition and restore volume there. I would want to see how everything looks after you heal from the facelift. From these pictures, it looks like your skin would likely also benefit from laser resurfacing to really give you the best possible results, but I would NOT do this at the same time as the facelift or browlift. When you perform laser resurfacing, you damage the skin from above, as you remove some of the outermost layer(s) to allow new, better quality skin to heal in from below. As a result, when you perform both a browlift or facelift and laser resurfacing at the same time, you are introducing insults to the skin from both above and below, further stressing/compromising the vascularity, and increasing the risk of skin/wound complications (e.g. delayed/poor wound healing, skin ischemia/necrosis, infection, etc). With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos you have provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! Best wishes, Dr. Donald Groves Plastic Surgeon