Sagging, puffiness, and overall tired look. Midface Rejuvenation? Suggestions more permanent than fillers?. (Photos)

I appreciate your concerns, however, you do have options. These options range from fillers and Botox to MACS mini facelift. I have performed this type of mini facelift procedure successfully on patients your age range who were reasonable candidates.Come see me or another board certified plastic surgeon in our area to explore the best options for you. Good luck.

Based on these photos, it appears that moderate malar hyperplasia (small cheek bones) is the cause of your tired look. A combination of transconjuctival lower blepharoplasty and cheek augmentation with cheek implants or fat grafting (or both) would be my suggestion. Good luck.

Based on your description, it sounds like you could benefit from a combination of surgical approaches for the most natural and long-lasting rejuvenation.
Upper and lower eyelid (blepharoplasty) surgery is very effective for addressing both puffiness and skin laxity around the eyes. This procedure removes excess skin and reduces fat bulges, resulting in a fresher and less tired appearance.
For the lower eyelid and midface (malar/infraorbital) area, fat grafting is an excellent option. Transferring your own fat to these regions can restore lost volume, improve contour, and address the hollow look that often develops in the infraorbital and malar areas with age. Fat grafting provides natural, long-lasting results compared to temporary fillers.
Additionally, considering your age and midface sagging, an endoscopic midface lift may be recommended. This technique can lift and tighten the midface tissues, enhance cheek projection, and create a more youthful facial contour. The results are more permanent and natural compared to injectable fillers.
Overall, you are a good candidate for a comprehensive surgical rejuvenation of the eye and midface region. Of course, a detailed in-person evaluation is necessary to tailor the best treatment plan to your anatomy and goals.

After carefully reviewing your photos, I would like to share my professional assessment and recommend appropriate surgical options tailored to your needs.Due to limited visibility in the photos, please understand that a precise evaluation is challenging; however, based on the visible features, the muscles responsible for eyelid opening appear weakened, and sagging skin is affecting the brightness of your eyes. Additionally, hollowness and wrinkles under the eyes contribute to an aged appearance.To address these concerns:Lower blepharoplasty can effectively rejuvenate the under-eye area by repositioning excess fat and tightening skin.Mid-face lifting is recommended to improve sagging and heaviness above the nasolabial folds.For eyelid concerns, sub brow lift can remove sagging skin, while a natural adhesion double eyelid procedure combined with ptosis correction can help improve eyelid function and aesthetic appearance.Each treatment has specific goals and expected outcomes, and I would be happy to discuss these options in detail during a consultation to ensure we choose the best approach for your unique needs.Fillers are a temporary treatment that restore volume to sunken areas; however, the degree of improvement they provide is limited.

Based on the close-up post of photos, which need more distant full face photos to really review your issues. I recommend a virtual consultation most likely a mid face mini type lift with the Endo laser could be a benefit. Expect fees to range from $10,000-$15,000. Best of virtual consult with

Midface volume restoration can be accomplished in a number of ways.
This includes implants, a midface lift, fillers, and fat grafting.
Each of these treatments have advantages and disadvantages.
Personally I have found fat grafting to be unpredictable.
Despite the need to retreat fillers are in many ways ideal.
Best,
Mats Hagstrom MD