Mid face lift or fillers? (Photo)

More information and an examination is needed, but usually, at your stage of life, descent of the five fat pads of the face, caused by weakening of the ligaments that hold them up, is the primary cause of a fallen mid-face.  Mid-face gravitational descent, not volume loss (which does occur) is most of the reason. This has been the conclusion of numerous articles and textbooks currently and over the years. It is not until much later in life, that severe volume loss occurs, though volume loss can contribute to gravitational descent.
 You seem to have orbitomalar, as well as zygomatic and MacGregor’s ligament weakening.  So your best bet is a sub-periosteal mid-face lift with either Endotine (done properly) or Gore-Tex fixation as we have published numerous times. 
Try smiling and see if your mid-face fallen volume is restored by the resultant induced melo-plication of your fat pads.  If so, a subperiosteal midface lift, done properly, should be helpful.
Nothing wrong with two or three vials of filler used every 3months to a year.  It will work for a period of time, but can, if overdone, give you a more “puffy” look.
A mid-face lift is often used as one of the tools to correct an ectropian, so should not cause one, unless a blepharoplasty is pulled upward.  Most often a mid-face lift is accomplished by a small incision in the temple, so does not pull the eyelid downward, but reinforces a proper eyelid position.
Your picture looks as if you have had some filler placed in the past (I might be wrong).  If so, you should inform your examining physician about this.
I’ve not mentioned another option, which is an “InstaLift” thread lift, which can also be done with a gore-Tex loop.  This can reposition the fat pads, but will not interrupt and re-position the ligaments.  The InstLift has a one year effect, and five years is common for the Gore-Tex suture loop lift.

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

I don't think a midface lift would be recommended for you.
I would start with a series of Sculptra injections to the right and left mid-cheek/malar area. This can be repeated every 4-6 weeks to get idea results.
Sculptra is not a filler per-se, but it will stimulate your own collagen over a period of time...and it will give you a very natural appearance. 

You have some anterior cheek and mid face issues with malar bags. A mid facelift through the lower lid incision can be helpful but caries some risk. Fillers like Resylane Lyft, Radiesse, or Voluma are very useful if done properly. I would stay away from any energy base procedure like the RFs and Ultherapy as they may melt additional soft tissue and make the matters worse.

To be honest with you I am not a fan of either fillers or the midface lift.  I think you need to be more specific regarding what you want to achieve so you will avoid disappointment in the future.

Thank you for your question and for sharing your photos . It is difficult to assess to what degree a 
mid-face lift will benefit you without physically assessing but from your photos you do not seem to need a facelift, fillers might be the best option. make sure you discuss your options with a board certified Plastic Surgeon.
Good luck 
Güncel Öztürk MD