What to do about lower face laxity, lifting and upper lip tightening? (Photo)

What I see on the pictures (and an in person consultation, or at least zoom is essential for evaluation) is that your mid-face seems to droop, and you may have tried to correct this with filler. A mid-face lift might improve things greatly. They are tricky to get "right", but work for years if done well. We have had over 30 years experience with them, but find that only about 5% of surgeons are comfortable with them. At UCLA, I've taught these techniques to many specialty facial plastic fellows, and most do well with them.

You have a good result from your facelift. Non surgical things are unlikely to give you further improvement but try them if you like

There are many ways to approach this problem and you have noted a few of them. We are familiar with the most widely used technologies and would suggest either Sofwave or SylfirmX. The Sofwave is ultrasound technology focused at to tighten the skin and also address skin texture issues. It is attractive because there is almost no downtime, and it is usually a "one and done" procedure. The SylfirmX is a form of bipolar radiofrequency treatment which requires a series of 3-5 treatments but can address both skin tightening and texture issues.

Although you’ve had a facelift recently, it appears that a secondary procedure, such as a deep plane, facelift, and or neck lift would be most appropriate for you. Deep plane allows us to address deeper structures, and create a more natural snatched look than traditional facelift procedures, if you’re interested in further discussion, please message me to set up a virtual consultation

Sandy,

You have had a facelift(which indicates a different procedure for different surgeons) and continue to work on skin tightening yet are not fully satisfied.
Sight unseen(not examined) that indicates either (1)a loss of skeletal definition, (2)facelift layer quality, ot (3) both.
I would suggest either fat grafting(done properly in the operating room they should last and rejuvenate the facial skeleton for 10-15 years) or a technique I have used since 2015 to non surgically rejuvenate, tighten and shape the deep facelift layer.
This will add longevity and definition to what you have already done
Hope this helps

To make an assessment on the outcome of a procedure we generally need to see a complete set of proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon who did your facelift to forward the pictures they took.
Based on the pictures you’ve included, you don’t appear to have a lot of skin laxity in your lower face.
Be careful with the radio frequency treatment, because they can destroy subcutaneous fat, leading to premature aging.
Best,
Mats Hagstrom, MD