SOOF lift or lower blepharoplasty? (Photo)

Rather than focus on what your next surgery will by, why not focus on how you can look your prettiest without being meddlesome and having too much surgery?When eyes are deep set, augmentation of the cheeks makes the eyes look sunken.Once your filler is dissolved or gone, you may want to consult conservative doctors with an artistic eye who can guide you on how to achieve a natural appearance and address your concerns.  I am concerned you are headed down the wrong path.

Thank you for your question. Please view my other post to your question. It is important that you always consult with a board certified facial plastic surgeon. During your consultation, you should discuss the benefits and risks of each potential procedure that you are considering.
Best wishes,

Befor plunging into eyelid surgery, have the old filler removed.  It is clear from the photos that you have retained filler that is causing the cheeks to be puffy.  Removing this product is the first step to getting you on the right track.  You photos also shows that you have profound upper eyelid ptosis and a compensatory brow elevation.  I think to need to find cosmetic surgeons who advocate for what is right for you not for their pocket book.

Hello,Thanks for your question. It is hard to help you based on the one photo you submitted. But, it sounds like you are most concerned with the malar festooning you see by the shadows thrown onto your cheek area. Filler is a basic option but filler to correct festooning can create swelling around the eyes if too much is injected. Laser resurfacing is often helpful to tone and tighten the lower lid and cheek areas. A SOOF lift with proper anchoring along with judicious skin pinch may be the best option overall. As to delayed ectropion, the risk is low if proper suspension is used. I would recommend that you consult with a facial cosmetic surgery specialist to get the best outcomes.Good luck,Dr. Shah

Thank you for your excellent question. It appears from the photo you provided that skin removal is not necessary in your case. I would discuss options with your plastic surgeon that involve removing, repositioning, and/or adding volume to elevate and soften the lid-cheek junction without removing any skin. 

You are right to be concerned about excisional blepharoplasty if you do not have extra lower eyelid skin. Adding volume to better blend the lower eyelid with the cheek can be a better alternative to improve lower eyelid aesthetics, but this can best be determined by examination, and your photo is insufficient to make the determination.