Under-eye and mid face rejuvenation options? (Photo)

The mid face does not descend vertically with aging process, but loses volume. For a temporary augmentation, consider fillers in the midface. For a permanent augmentation, consider cheek implants.

Midface facial aging is somewhat complex and you may find different providers have different opinions on how to approach this.
There are often two dynamic variables that show the signs of aging in this facial region.
In a youthful, attractive face, the contour of the lower eyelid is typically snug And tight with immediate plump fullness in the beginning of the mid face.
With facial aging the two areas reverse in contour.
Bulging and fullness develops in the lower eyelid as the fat pads under the lower eyelids begin to show due to weakness of the Peri-orbital septum at the same time patients may begin to lose volume in the upper part of their midface.
Sometimes bulging fat pads in the lower eyelids is the primary cause other times a lack of volume in the midface is primary, and sometimes it simply 50-50.
In your case, I think loss of volume which is primarily based on facial, skeletal structure, is more of the primary cause than bulging fat pads in the lower eyelids.
Restoring midface volume can be done, using fillers, fat, transfer, using implants or a mid facelift.(very different than regular facelift.)
Of these options fillers are probably the best in regards to being precise, predictable, and highly forgiving if patients don’t like the outcome.
The biggest drawback is the lack of permanence.
This can, however be a blessing patient don’t like the outcome of a treatment. I recognize the Baybridge in the background of your picture. Based on that I recommend you take a look at the website of Dr. David Mabie MD in San Francisco.
He is a facial plastic surgeon whose work is devoted exclusively to only working with facial fillers.
His work using fillers is the best I’ve ever seen, and in my opinion is work is the gold standard of what can be achieved without surgical intervention.
His work doesn’t come cheap, but his work is in my opinion the best I’ve ever seen.
I typically don’t recommend people get a flight and fly across the country to have fillers done but for those who live in the area, it may be a very legitimate option.
If nothing else, looking at his results, can give you an idea of what well done volume restoration is able to accomplish.
Some of his results are absolutely stunning.
Best,
Mats Hagstrom, MD