Recommend Facial Fat Transfer for 74-year-old Woman?

I do not find that fat transfer, fat grafting or fat injections (all the same procedure) are very effective around the mouth area. The volume depletion of the cheeks can be augmented quite nicely by fat injections. Smile folds can also be treated well but usually don't last as long as the fat injections into the cheeks. Sculptra volumization is similar in volume and cost to fat injections, but Sculptra lasts up to two years in some patients, less or more in others. Fat may not work in some patients but in others the grafted cells "take" and live for years after a series of treatments. Both Sculptra and Fat injections could be of similar cost depending on the amount of Sculptra needed. There may be long-term correction of the fat injections and then your amortized cost becomes less than other fillers that last less than one year.

Fat is a great option after multiple facelifts to volumize the face. Aging can be seen as a process of changing from a grape to a raisin for lack of a better descriptive scenario. Facelifts essentially make the raisin into a smaller raisin. When in fact to look younger a lot of times looking like a fuller younger naturally looking grape is the better option. This is where volumizing plays an important role.
Fat injections volumize the face to return the raisin to the grape that it used to be. Given that you have had 2 facelifts, you likely have a reduced skin volume and hence you will be smaller than the grape you once were, unless you gained alot of weight during the years. Volumizing would be excellent for you likely. But it all depends on what you look like and this is a general comment.
At the age of 74, you can still get benefits from facial fat grafting. I have done a lot of patients over this age. It all depends on your health. Of course you need enough fat to do the procedure and your surgeon can tell you about that or assess this situation.

Yes to all your questions. I would recommend this procedure to give you fuller cheek and to correct the nasolabial folds. It is a wonderful adjunct to your previous facelift procedures and is relatively low risk at your age. It is typically significantly more expensive than a filler as it is a permenant soluation and involves minor surgery.