How to fix my sagging skin and under eye wrinkles! Botox? High? Laser? Filler? Skin tightening hifu? Rf? (photos)

From your photos, it looks like a very small amount of botox under your eyes might do the trick. Please have your doctor check the laxity of the skin by doing a "snap test" before injecting under the eyes. Microneedling, HIFU or fractional laser combined with PRP would also be a good way to address the loose skin and build collagen. 

Preferably a member of the American Society for Aesthetic plastic surgery, this will assure you of their proper training in cosmetic surgery. After an in person consultation your doctor should be able to determine what is best for you. Most likely you will need a combination of treatments, there is nothing that can  fix by itself, all the problems seen with facial aging, you will need skin care, fillers, botulism toxin, and eventually surgery.

Don't be discouraged at the changes you are noticing; there is help.  Consult in person with experienced board certified plastic surgeons, cosmetic dermatologists or ocouloplastic surgeons.  There are a variety of non-surgical options available based on your photos. Regular use of Botox or Dysport will begin to reduce the lines around the eyes.  Proper sun protection and professional skin care products will be beneficial.  At the current stage, Erbium or CO2 laser are probably not needed, though light peels may be.  Facelift would not be beneficial for the conditions you describe.  Each practitioner you visit will probably offer a somewhat different approach, but the consultation process will help you make the best decision.  

Hi CharleaKerry,Let's start with proper skincare and sun protection. Then some Botox and microneedling with PRP. For loss of volume through weight loss or aging, please ask your doctor about Sculptra. It is long acting but it will be some time before you see results. Sculptra is not just a filler - it also build up collagen. If you feel you need a lift, your doctor can use Voluma or Restylane Lyft. You have very beautiful features and a nice smile. So don't worry.All the best, Justin Harper, M.D.