Face balance. What would you recommend for soft enhancement? (Photo)

Hello and thank you for your question. When it comes to soft tissue enhancement, in addition to dermal fillers which you had mentioned, fat grafting is an excellent option. Fat grafting adds volume to specific areas of your face by taking the fat from your abdomen or thighs, and injecting it into your face. This is your body's own natural tissue, so you don't have to worry about rejection or reactions to the injected material. Once the fat "takes" (lives and integrates into the new injected site), the results last a long time. This differs from hyaluronic acid (HA) filler, the most common type of filler, which typically degrades over about a 12 month period, meaning you need periodic re-injections to maintain the results..You might benefit from some filler or fat grafting to your cheeks around your infraorbital rims, but it is difficult to provide even tentative recommendations, as there is only so much information to be gained from the one photo you have provided. I would recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, be formally examined, 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

Your nose looks like there may have been some cartilage grafts in the tip. This is making your tip look thick. I’d be interested in other views of your nose. Revision may be worthwhile

I strongly recommend you do not double down with more bad surgery. You are holding a significant amount of funky filler volume low in your cheeks. Likely you have had so-called "smooth" fillers in your cheek by well meaning injectors. There are products like Juvederm and Voluma. Marketers make it sound like these are amazing fillers and for the right application they are fine. However these fillers do not simply disappear from the face. Rather, long after they no longer work for us clinically, and we may even have been topped off with more filler, these old fillers persist. So-called smooth fillers drift in the face eventually making its way lower in the cheeks. The cheek volume is making you look older. Rather than get facial surgery, I recommend you remove as much of this old filler as possible. You also have upper eyelid ptosis and this could be managed with the drop Upneeq on a temporary basis for special occasions or surgically. The ptosis surgery that might be right for you needed to be determined based on an in person consultation. I would start with the removal of the filler. Its removal will make you look 10 years younger.