Do I need fillers or a thread lift?

Thread lifting has a long history with both very beautiful results and happy patients mixed with poor results and dissatisfaction. Most of the latter stems from the use of permanent sutures and poor technique.
Most modern thread lifting utilizes absorbable sutures, which have many major benefits. These threads not only lift and support, but provide volume as they go away, creating a lift and fill effect. The risk of dimpling, an issue with the old thread lifts, is zero here as these are not providing a permanent pull. 
These modern thread lifts are best thought of like a filler. They will do their job for a year or two and then will need to be touched up, but the results in the meantime are beautiful.
Choosing your physician wisely here is key, as knowledge of normal facelift anatomy, tissue movement and technique is a highly valuable skill when placing these absorbable lifting threads.
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut#realself500 Physician

Thank you for your question and photo. Lifting the midface would have a very positive effect on both your nasolabial folds and the downturned corners of your mouth. This might be best achieved with a thread lift. The latest threads offer very good results with minimal side effects and can last 6-12 months for most patients. The procedure does not require anesthesia and the threads can be strategically placed to produce very natural results. As the threads dissolve over time, collagen levels in the skin increase to prolong the improvement. You might also consider some injectables with your thread lift to further enhance your results. Neuromodulators like Botox work on lines that are the result of repeated facial expressions, while dermal fillers restore volume to key areas to smooth away wrinkles from the inside out. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan that meets your needs and goals best.

Thank you for sharing your question and posting your photo. Both options are usually good, but an in person examination by and experienced oculofacial surgeon would be best to determine exactly what would work for you. Often, a combination approach is an excellent choice. From your photo, it looks like you could benefit from both options. Good luck!