Need advice. Endoscopic midfacelift, deep plane facelift. No longer filler/threadlift

Your age would be an important factor in deciding the treatment options. You have however rightly picked up the problem areas in your face, most of which apart from the jowls are related to midface ptosis. So it is certainly reasonable to consider a midface lift as the ideal treatment for you . This can be done through both open and endoscopic approach and depends o the skills of the surgeons you are seeing and their preference and familiarity with which technique they can get a better result. True that if you are looking for a more comprehensive facial rejuvenation, that is to improve the jowls as well, then facelift would be a better option. Your jowl are relatively mild and will certainly be less of an issue after having a midface lift alone. A word of caution, there are very few surgeons that routinely offer midface lift as this can be associated with higher risks of complication, particularly lower lid deformities that will subsequently need corrective surgery. However if you do find the right surgeon, i would suggest having a midface lift for now and consider the full facelift at a later stage of your life.

Thank you for your question. The terms used for a facelift can vary from surgeon to surgeon, making it difficult to compare one procedure to another. Based on the concerns you have listed, your best bet might be a mini facelift to address signs of aging in the lower face and a lower blepharoplasty to refresh the areas under the eyes. Another option could be a full (deep plane) facelift with blepharoplasty or tear trough fillers under the eyes for rejuvenation. The deep plane facelift will provide the most durable results, with improvements lasting 10 years or more in most cases. No matter which combination you choose, you could have all of the surgical treatments in the same session. I encourage you to seek advice from a board-certified facial plastic surgeon who has the expertise and knowledge of facial anatomy to customize your treatment plan for the best possible result.

Thank you for your question. If you don’t want fellers and non invasive procedures your only alternative will be surgery. It is important that you have a consultation with a Board Certified Plastic surgeon that explain the advantages of a deep plane in terms of given you volume and natural results.

It is important to weight the potential benefits and risks with all procedures, especially aesthetic surgery. While a midface lift can help improve the appearance of "heavy" cheeks, especially the appearance of deep smile lines extending to the base of the nose, a midface lift carries a relatively high risk of causing changes in the shape and position of the lower eyelid (which can be disfiguring). Midface lifts became very popular several decades ago but have gradually fallen out of favor with most Plastic Surgeons due to these potential complications.
A Deep Plane facelift is a powerful tool to help improve lower facial aging changes (jowls, neck, heavy lower lateral cheek), and has a moderate effect on the medial cheek (i.e. closer to the nose). As a means to improve the shortcomings of a facelift on the medial cheek (deep smile lines near the base of the nose), fat grafting can significantly compliment the results. The other benefit of a deep plane facelift is that it will not risk altering your lower eyelid position/eyelid shape.
If you are bothered by the lines/circles beneath your eyes, I would recommend a transconjunctival lower blepharoplasty (incision inside the lower eyelid - no visible external incision). Fat grafting can further compliment the result by blending the transition of your lower eyelids to your upper cheeks.