Is a lower/mid facelift right for me? (Photo)

Based on your description and photos, it seems that the sagging around your mouth and mid-face region could benefit from a more comprehensive surgical approach. Given your concerns and previous treatments, a deep plane facelift might be the most effective option for you.
This technique addresses not only the skin but also the deeper layers of facial muscles and tissues, providing a more natural and longer-lasting lift, especially in the mid and lower face. It can restore youthful contours and improve sagging more effectively than surface-level treatments.
Of course, a thorough in-person evaluation is essential to confirm candidacy and tailor the procedure to your specific anatomy and goals.

This procedure uses an incision in the temporal hairline to lift your cheeks and correct jowl fullness, even a bit of the neck. It is a great procedure for younger patients looking for a safe and effective rejuvenation procedure with minimal downtime. It would correct your nasolabial folds and marionette lines.

At 33, I think you are too young to do a lower/mid facelift. What I recommend instead is a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. You may also benefit from a chin implant and also a rhinoplasty. You have a dorsal hump that could remarkably improved as well as the angle of the nose.

Best Wishes,

Gary Horndeski, M.D.

It would be difficult to give you good advice without in person evaluation and discussion about your concerns and goals. Extended neck lift, small chin implant, chemical peel would be few procedures to consider but direct communication with a board certified plastic surgeon with expertise in facial rejuvenation is strongly recommended. Good luck.

At least from the photos provided, the upper cheek and chin areas are not the particular problem areas, so no surprise that fillers did not solve the problem there. I stopped using threads quite a few years ago owing to its high complication rates and disappointingly short-lived results. So, again no surprises there. And chemical peels and microneedling are better suited to treating superficial color and texture issues of the "fabric" of the skin, so there would have been no significant improvement of any kind expected from either of these approaches.
From the photos, the major issue lies in volume deficit in the lower third of the face. If that is indeed the case then the appropriate choice of a robust, HA Contouring filler in the hands of an experienced, board certified cosmetic dermatologist filler expert injected properly in the lower third of the face would likely not only create a more desirable, gradual oval shape to the entire face, but would likely secondarily improve the smile lines, as well. Hope this helps and best of luck.

Based on your nice post of photos, I recommend an in person or virtual consultation. But my recommendation at this point would be a mini face neck lift with muscle plication, end treatment to face. Fee from $10,000-$20,000. Again, best of virtual consult with.