Should I consider a cheek lift? (Photo)

From the photos, the main issue appears to be volume deficit in the cheeks, which in turn is responsible for the under eye tear trough formation, the deep smile lines and the incipient marionette lines at the angles of the mouth. Appropriate revolumization with a robust filler, such as Voluma XC, would likely go a long way to nonsurgically recontouring your face into a more ideal heart-shaped appearance and to secondarily improving the smile folds and even to some extent the downturning at the corners of the mouth. The key here is finding an experienced board certified cosmetic dermatologist or other core aesthetic physician. Make sure to ask to see his/her personal befores and afters before agreeing to proceed. Bottom line: no need for surgery. A twenty minute filler treatment should do the trick.

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Thank you for your question and photos. Based on the images, it appears your primary issue is volume loss in the midface, which could be addressed with some injectable filler or facial fat grafting. Either of these procedures would also minimize the lines in the lower portion of the face as well, although some additional dermal filler could also be placed directly into the lines if necessary. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a personalized treatment plan that will meet your needs and goals best.