Filler vs. PDO threading? (Photo)

PDO threads are a waste of your time and money and will not give you any lasting benefit. I cannot recommend them. Fillers may help change the shape of your face, but will also add volume which you may or may not want in your face. A small amount of filler under your eyes may be a nice change and help soften the transition from your eye to your upper cheek. A mini-facelift can easily reposition your face to it's youthful state and get rid of the excess skin you have mentioned in your neck. IR therapy like Thermage may be helpful to tighten some areas of skin laxity slightly, but they also create subdermal scar so please be aware of the risks and benefits of the treatment. 

Even facelift surgery is often accompanied by volume replacement and resurfacing whether chemical peels or laser treatment.to help create a straigher jawline, botox along one's upper lateral neck below the jawline and in the neck vertical platysmal bands can reshape the neck and a tightening device such as Ultherapy, Thermage, ThermiSmooth or ThermiTight can help lift the lower face, along with providing extra support in the infrastructure of the skin such as Voluma, Radiesse, Restylane Lyft, etc.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

You are a face lift and volume candidate, you need both.  if you are not willing to have a facelift at this time, then threads , ultherapy and thermage are your only option for lifting. I use a combination of both PDO and instalift to get maximum results.  I suggest a combination approach of :
1) skin care with products and PRP/microneedling

2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel, Viva, doctor fake diacomo urtisor Co2/Erbium
4) Sculptra injections a few times a year for collagen production
5) thermage/ultherapy for yearly skin tightening6) threads for immediate lifting7) fillers on top of t he sculptra t o build more volume that you lack specifically in the midface, templates, folds, and under eyes.Best, Dr. Emer.

There such a great variety of safe and cost effective dermal fillers for all areas of face including tear troughs. The relative safety and very high rate of patient satisfaction wiht HA fillers puts you in the drivers seat.  See how things look after filler treatment before deciding what you want to do next with other treatment modalities.
Remember this - Dermal Fillers have unmatched 'bang for the buck' in field of facial aesthetics and rejuvenation.
Good luck and show us some after pics!

I think you are a great candidate for combination treatment using midface/cheek filler (Restylane Lyft or Sculptra Aesthetic) and a nonsurgical skin tightening procedure (Thermage CPT). I would combine this with a good at home skincare regimen which includes a sunscreen, antixoidant, retinol, and peptides. 

I would definitely recommend a combination of Thermage and fillers such as Sculptra and Juvederm Voluma.  Botox won't help this area of the face at all but the combination of Thermage and fillers will give you the collagen and the lift that you need. Please consult an expert in these procedures for the best results. Best, Dr. Green

Hi,Fillers may improve the upper cheek sagging altough this is a temporary fix. The loose skin or plastyma banding can be improved with botox injections although this is also a tempory fix. Best,Dr.S.